Page 1

June 2017 Volume 9  Issue 6

THE INDEPENDENT VOICE OF PHARMACY

Winners Issue

In this issue:

®

1

#1 Selling OTC Allergy Brand in the world1

Fast NON-DROWSY relief of hayfever and other allergy symptoms in 1 tablet: • Sneezing • Runny nose

NEWS: Doubts expressed over Minor Ailment Scheme promotion Page 5

PROFILE: Nicola Abbott of Cellnutrition Page 18

FEATURE: Female Heath and the Pharmacy Page 31

FEATURE:

• Itchy eyes

What is Migraine Page 38

CPD: Skin Cancer Page 49 Clarityn 10mg Tablets (Loratadine) For full details, please refer to full SmPC. Presentation: Tablet containing 10mg loratadine. Indication: For the symptomatic treatment of allergic rhinitis and chronic idiopathic urticaria in adults and children over the age of 2 years with a body weight more than 30 kg. Dosage and Administration: Adults and children over 12 years of age: 10 mg/1 tablet orally once daily. Children 2 to 12 years of age with body weight > 30 kg: 10 mg once daily. Use other formulations for children 2 to 12 years old with a body weight 30 kg or less. The safety and efficacy in children under 2 years have not been established. Renal impairment: No dosage adjustments are necessary in patients with impaired renal function. Hepatic impairment: Patients with severe liver impairment should be administered a lower initial dose because they may have reduced clearance of loratadine. An initial dose of 10 mg every other day is recommended for adults and children weighing more than 30 kg. Contraindications: Hypersensitivity to loratadine or to any of the excipients.Warnings and Precautions: Clarityn should be administered with caution in patients with severe liver impairment. Contains lactose; patients with rare hereditary problems of galactose intolerance, the Lapp lactase deficiency or glucose-galactose malabsorption should not take this medicine. Administration of Clarityn should be discontinued at least 48 hours before skin tests since antihistamines may prevent or reduce otherwise positive reactions to dermal reactivity index. Interactions with other medicinal products: Clarityn has no potentiating effects when administered concomitantly with alcohol. Potential interaction may occur with all known inhibitors of CYP3A4 or CYP2D6 resulting in elevated levels of loratadine, which may cause an increase in adverse events. Increase in plasma concentrations of loratadine has been reported after concomitant use with ketoconazole, erythromycin, and cimetidine in controlled trials, but without clinically significant changes (including electrocardiographic). Interaction studies have only been performed in adults. Fertility, pregnancy and lactation: There are no data available on male and female fertility. It is preferable to avoid the use of Clarityn during pregnancy. Clarityn should not be used during breast-feeding. Effects on ability to drive and use machines: Clarityn has no or negligible influence on the ability to drive and use machines. However, patients should be informed that very rarely some people experience drowsiness, which may affect their ability to drive or use machines. Undesirable effects: Very rare: hypersensitivity reactions (including angioedema and anaphylaxis, dizziness, convulsion, tachycardia, palpitation, nausea, dry mouth, gastritis, abnormal hepatic function, rash, alopecia, fatigue. In clinical trials in children aged 2 to 12 years, somnolence, headache, nervousness and fatigue were commonly reported and headache, increased appetite and insomnia were reported uncommonly. Classification for sale or supply: pharmacy-only. MA numbers: PA1410/75/1 Further information available from the Marketing Authorisation Holder: Bayer Ltd., The Atrium, Blackthorn Road, Dublin 18. Tel: 01 2999313. Date of Preparation: November 2015

Reference: 1. Internal calculations derived from QuintilesIMS OTC Global Analysis database, MAT 6/2016.

L.IE.MKT.05.2016.0336

AWARDS: Irish Pharmacy Awards take place in Dublin’s Clayton Hotel Page 54


Introducing Altavita® D3 7,000 IU and 25,000 IU soft capsules

Licensed for prevention and treatment of vitamin D deficiency

Vitamin D Deficiency: Altavita D3 - A range designed for compliance

The Altavita D3 range now offers a choice of weekly and monthly vitamin D3 medicines for the prevention of vitamin D deficiency

Always prescribe Altavita® D3 by brand name

www.altavita.ie

IE/ALT/0217/0056. Date of preparation: February 2017 Abbreviated Prescribing Information - for full prescribing information, including side effects, precautions and contra-indications, see Summary of Product Characteristics (SmPC)

Product name and Composition: Altavita D3 7,000 IU soft capsules. Each capsule contains 7,000 IU colecalciferol (equivalent to 0.175 mg vitamin D3). Altavita D3 25,000 IU soft capsules & Altavita D3 25,000 IU single dose oral solution: each capsule or single dose oral solution contains 0.625 mg colecalciferol, equivalent to 25,000 IU vitamin D. Indications: Altavita D3 25,000 IU soft capsules: Treatment and prophylaxis of Vitamin D deficiency in adolescents and adults with an identified risk. As an adjunct to specific therapy for osteoporosis in patients with Vitamin D deficiency or at risk of Vitamin D insufficiency. AltaVita D3 25,000 IU oral solution: Prevention and treatment of Vitamin D deficiency. As an adjunct to specific therapy for osteoporosis in patients with Vitamin D deficiency or at risk of Vitamin D insufficiency. Altavita D3 7,000 IU soft capsules: Prophylaxis and treatment of vitamin D deficiency in children, adolescents and adults with an identified risk. Prophylaxis of vitamin D deficiency in pregnant and breast-feeding women with an identified risk. As an adjunct to specific therapy for osteoporosis in patients with vitamin D deficiency or at risk of vitamin D deficiency. Dosage and administration: Altavita D3 7,000 IU soft capsules: Suitable for weekly supplementation, which should be taken into consideration and dosage should be established by a physician. The dose of 1,000 IU/day is considered equivalent to 7,000 IU/week. Pregnancy and breastfeeding: Doses of 1,000 – 2,000 IU/day may be required to prevent deficiency in some women (see below). Even higher doses may be required during breast-feeding if women choose not to give the infant a vitamin D supplement. Adults - prevention of vitamin D deficiency 1,000 IU/day. As an adjunct to specific therapy for osteoporosis: 1,000 IU/day. Treatment of deficiency: 1,000 IU – 4,000 IU/day for up to 12 weeks, followed by maintenance therapy of 1,400 – 2,000 IU/day, such as two 7,000 IU soft capsules per week). Altavita D3 25,000 IU soft capsules: Children aged 10-18 years: Prevention of deficiency, 25,000 IU (1 capsule) every 6 weeks. Treatment of deficiency, 25,000 IU (1 capsule) once every 2 weeks for 6 weeks followed by maintenance therapy of 400 – 1,000 IU/day, such as 1 capsule per month. Pregnancy and breastfeeding: The high strength formulation is not recommended. Altavita D3 25,000 IU soft capsules & Altavita 25,000 IU Oral Solution: Adults: Prevention of deficiency, 25,000 IU/month (1 capsule or single dose oral solution); higher doses and monitoring of serum 25(OH)D may be required in populations at high risk of vitamin D deficiency (* see below) Adjunct to specific therapy for osteoporosis, 25,000 IU/month (1 capsule or single dose oral solution). Treatment of deficiency (<25 nmol/L), 50,000 IU/ week (2 capsules or single dose oral solution) for 6-8 weeks followed by maintenance

therapy 1,400 – 2,000 IU/day, may be required such as 2 capsules or oral solutions per month; follow-up 25(OH)D measurements should be made approximately 3-4 months after initiating maintenance therapy to confirm that the target level has been achieved. Altavita 25,000 IU Oral Solution: Paediatric posology: Prevention of deficiency 0-1 years 25000 IU (1 single dose oral solution) every 8 weeks, Prevention of deficiency 1-18 years 25,000 IU (1 single dose oral solution) every 6 weeks. Treatment of deficiency 0-18 years 25,000 IU (1 single dose oral solution) once every 2 weeks for 6 weeks (followed by maintenance therapy of 400-1000 IU/day). *Altavita D3 7,000 IU soft capsules , Altavita D3 25,000 IU soft capsules & Altavita 25,000 IU Oral Solution: Populations at high risk of vitamin D deficiency include those who are institutionalised or hospitalised, dark skinned, obese, being evaluated for osteoporosis, with limited effective sun exposure due to protective clothing or consistent use of sun screens, using certain concomitant medication e.g. anticonvulsants or glucocorticoids, with malabsorption, including inflammatory bowel disease and coeliac disease and recently treated for vitamin D deficiency, and requiring maintenance therapy. Special populations: Altavita D3 25,000 IU soft capsules and oral solution should not be used in combination with calcium in patients with severe renal impairment. Administration to Adults: Altavita D3 should be taken orally – the capsules should be swallowed whole with water, for the oral solution the full contents of the single dose oral solution should be either emptied into the mouth and swallowed orally, or emptied onto a spoon and taken orally. AltavitaD3 can also be taken by mixing with a small amount of cold or lukewarm food immediately prior to use. Patients should be advised to take AltaVita D3 25,000 IU preferably with a meal. Administration to children: In children, Altavita D3 Oral Solution can be mixed with a small amount of children’s foods, yogurt, milk, cheese or other dairy products. Parents should be warned not to mix Altavita D3 oral solution into a bottle of milk or container of soft foods in case the child does not consume the whole portion, and does not receive the full dose. They should ensure that their child takes the entire dose. For children who are not breast-feeding, the prescribed dose should be administered with a meal. Contraindications: Altavita D3 7,000 IU soft capsules, Altavita D3 25,000 IU soft capsules & AltaVita 25,000 IU oral solution: Hypersensitivity to the active substance or to any of the excipients; hypercalcaemia and/or hypercalciuria; nephrolithiasis and/or nephrocalcinosis; hypervitaminosis D. Pregnancy and breastfeeding: Due to lack of clinical data Altavita D3 25,000 IU is not recommended. Warnings and precautions: Use with caution in impaired renal function; monitor effect on calcium and phosphate levels. Consider the risk of soft tissue calcification. Exercise caution in patients receiving treatment for cardiovascular disease as concomitant administration of vitamin D with drugs containing digitalis and other cardiac glycosides may increase risk of digitalis toxicity and arrhythmia; strict medical supervision is

needed, with serum calcium concentration and electrocardiographic monitoring if necessary. Use with caution in patients with sarcoidosis due to possible increase in vitamin D metabolism; monitor serum and urinary calcium levels in these patients. Allow for the total dose of vitamin D where patients consume treatments and / or foodstuffs enriched with vitamin D and for the patient’s level of sun exposure. Possible risk of renal stones, especially with concomitant calcium supplementation; consider the need for additional calcium supplementation for individual patients. Calcium supplements should be given under close medical supervision. For a full list of interactions see the full SmPC. Altavita D3 25,000 IU soft capsules contain Allura Red AC (E129). Altavita D3 7,000 IU Soft Capsules contain Sunset Yellow FCF (E110). These excipients may cause allergic reactions. Undesirable effects: Not known (cannot be estimated from the available data): Hypersensitivity reactions such as angio-oedema or laryngeal oedema Uncommon (>1/1,000, <1/100): Hypercalcaemia and hypercalciuria. Rare (>1/10,000, <1/1,000): pruritus, rash, urticaria. Price: Altavita D3 7,000 IU soft capsules: GMS reimbursed at €3.28 per pack of 4 capsules. Altavita D3 25,000 IU soft capsules: GMS reimbursed at: €6.00 per pack of 3 capsules. Altavita D3 25,000 IU Oral Solution: GMS reimbursed at €6.00 per pack of 3 x 1ml single dose oral solution. Legal Classification: POM. MA number: Altavita D3 7,000 IU soft capsules PA 1876/5/2 Altavita D3 25,000 IU soft capsules: PA1876/004/0033, Altavita D3 25,000 IU Oral Solution PA1876/002/002. Marketing Authorisation Holder: Consilient Health Limited, 5th Floor, Beaux Lane House, Mercer Street Lower, Dublin 2, Ireland. Further information is available on request from Consilient Health Ltd. Block 2A, Richview Office Park, Clonskeagh, Dublin 14 Ireland, 01 2057760 or drugsafety@consilienthealth.com. Date of preparation of prescribing information: February 2017. ● Healthcare professionals are asked to report any suspected adverse reactions. To report an adverse event or a product complaint about a Consilient Health medicine, please contact Consilient Health at drugsafety@consilienthealth.com or 01 2057766 ● Adverse events and product complaints may also be reported to the Health Products Regulatory Authority. Reporting forms and information can be found at www.hpra.ie then click on “report an issue”.


Contents Page 4: Pharmacy Union issues call for drug reform

Page 6: Patrick McCormack steps down from Sam McCauley Group

4

Page 9: IPU Annual Conference

Page 24: Low vaccine uptake due to ‘misinformation’

6

Page 42: United Drug announce investment during annual Pharmacy Show

MANAGING DIRECTOR Natalie Maginnis n-maginnis@btconnect.com EDITOR - Kelly Jo Eastwood kjeastwood@hotmail.com

9

JOURNALIST - Paulie Doyle editorial@ipnirishpharmacynews.ie

SALES AND MARKETING Aisling Twomey aisling@ipnirishpharmacynews.ie CONTRIBUTORS Tomas Deasy Amy Oates DESIGN DIRECTOR Ian Stoddart Design June IPN ad - OTC Top Sellers.pdf

Regulars

One pharmacist involved in the pilot scheme, who did not wish to be named, told IPN that they didn’t believe the Scheme was adequately promoted by the HSE Also in the news, Carlyle Cardinal Ireland (CCI), the private equity fund established by The Carlyle Group (NASDAQ: CG) and Cardinal Capital Group, has agreed an investment in Sam McCauley Chemists Limited, the independent retail pharmacy group.

PUBLISHER IPN Communications Ireland Ltd. Clifton House, Lower Fitzwilliam Street Dublin 2 00353 (01) 6690562

ADVERTISING MANAGER Nicola McGarvey nicola@ipnirishpharmacynews.ie

The announcement was made at the annual IPU conference in Dublin in May. Mr Connolly said that, for people who are not yet dependent on drugs, efforts should focus on preventing dependence and reducing the harm associated with drug use. The HSE’s commitment to the Minor Ailment Scheme (MAS) has been questioned by a pharmacist involved in the project. The Minor Ailment Scheme was piloted across 19 pharmacies in four towns, (Kells, Roscommon, Macroom and Edenderry) for three months.

Page 12: Public show support for Pharmacy services

COMMERCIAL MANAGER Barry Maguire Barry@ipnirishpharmacynews.ie

In May, we saw the Irish Pharmacy Awards take place in Dublin, with 650 industry professionals in attendance. All of the staff at IPN Communications would like to thank everyone who attended and made the night so special, and our best awards yet. Full coverage is on page 54. Meanwhile, in the news, IPU President Daragh Connolly called for drug addiction to be treated as a health issue rather than a criminal one, and welcomed the news that safe-injection centres are currently being planned by the government.

Page 5: Doubt expressed over Minor Ailment Scheme promotion

ACCOUNTS Jon Dickinson accounts@ipncommunication.com

Foreword

Irish Pharmacy IRISH News is circulated PHARMACY to all independent, NEWS multiple and hospital pharmacist, government officials and departments, pharmacy managers, manufactures and wholesalers. Buyers of pharmacy groups and healthcare outlets. Circulation is free to all pharmacists subscription rate for Irish Pharmacy News ¤60 plus vat per year. All rights reserved by Irish Pharmacy News. All material published in Irish Pharmacy News is copyright and no part of this magazine may be reproduced, stored in a retrieval system of transmitted in any form without written permission. IPN Communications Ltd. have taken every care in compiling the magazine to ensure that it is correct at the time of going to press, however the publishers assume no responsibility for any effects from omissions or errors. 1

18/05/2017

17:34

Feature: Hayfever CPD: Skin Cancer

36 49

The investment, terms of which are not being disclosed, is expected to complete before the end of the summer. Turn to pages 4, 5 and 6 for details. An initiative to increase vaccination uptake was launched this month, with the Minister for Health attending and saying that low uptake of the HPV vaccine was due to misinformation. This month in our features we also look at allergies, female health, migraine, and medication adherence and cardiovascular disease while in our CPD section we discuss management of Skin Cancer and Melonoma. Lastly, this issue also features coverage of The United Drug Pharmacy Show, which took place took place last month, with businesses both big and small attending. IPN caught up with some of the teams there over the weekend. Turn to page 42 for details of the event.

Feature: Cardiovascular Disease

82

Product Profiles Clinical Profiles

96 97

Ignite Potential.

OTC Top Sellers Reports Group Level Store Level

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News news brief 64% OF BLOOD PRESSURE PATIENTS SHOW SOME FORM OF HYPERTENSION A review of Boots’ 24 Hour Blood Pressure Service has found that 64% of patients displayed some form of hypertension, with men showing a significantly higher prevalence than women; 74% compared to 56%. Over a third (34%) of people in Ireland are unaware that they have high blood pressure compared to 29% of people in England, and 17% in Canada. The survey was conducted as the chain announced that it is to provide Free blood pressure checks nationwide to mark May Measurement Month, a global initiative that aims to test 25 million people for high blood pressure. High blood pressure, also known as hypertension, is a common condition which affects approximately 30-40% of people in Ireland, and it is estimated that 62% of those aged over 45 have this condition, yet almost half of those affected (45%) are unaware that they have the condition. If left untreated, it can cause a significant number of cardiovascular conditions including stroke, heart attack and kidney failure. May Measurement Month, organised by the International Society of Hypertension and the World Hypertension League and supported by Boots Ireland, aims to test adults who have not had their blood pressure measured for at least a year. The results will be analysed and used to highlight the importance of knowing blood pressure measurements in order to take action and reduce the global burden of hypertension. Dr Eamon Dolan, Stroke Physician, Connolly Hospital, and Chair of the Irish Heart Foundation’s Council on Blood Pressure said, “Not enough people routinely get their blood pressure checked. The lack of awareness and high prevalence of hypertension are key issues in the fight against this silent killer. High blood pressure is the leading cardiovascular risk factor for attributable deaths and events such as stroke, yet it can be managed effectively once diagnosed in most people.

4

IPU calls for drug reform The President of the Irish Pharmacy Union (IPU) Daragh Connolly has called for the taking of illegal drugs to be treated as a health issue as opposed to a criminal one. The announcement was made at the annual IPU conference in Dublin in May. Mr Connolly said that, for people who are not yet dependent on drugs, efforts should focus on preventing dependence and reducing the harm associated with drug use. “For people suffering from drug dependence, health systems have to provide access to comprehensive treatment, including psychosocial support, pharmacotherapy and the prevention and management of associated health problems such as HIV, tuberculosis, viral hepatitis, mental health disorders and drug overdose,” he said. He said he welcomed the recent enactment of the Misuse of Drugs (Supervised Injecting Facilities) Act to provide for the establishment, licensing, operation and regulation of supervised injecting facilities for the purposes of reducing harm to people who inject drugs; to enhance the dignity, health and wellbeing of people who inject drugs in public places; to reduce the incidence of drug injection and drug-related litter in public places and, thereby, to enhance the public amenity for the wider community. “Pharmacists should be at the vanguard of this changing

IPU President Daragh Connolly

approach. We already provide opiate substitution using methadone; we provide needle exchange services in areas of need; we provide a crucial point of contact with healthcare for those whose problems have made them outsiders in our society. We want to do more,” he said. Seconding the motion, Ms Kathy Maher welcomed the recommendations of the Joint Committee on Justice, Defence and Equality in its Report of the Committee on a Harm Reducing and Rehabilitative Approach to

Possession of Small Amounts of Illegal Drugs, published in November 2015. Ms Maher said that discretion should remain with An Garda Síochána as to whether a civil/ administrative response or a criminal sanction was appropriate. “Indeed, the Oireachtas Committee acknowledged that no single treatment approach is effective for all persons and the harm reducing and rehabilitative approach must be flexible and appropriately resourced to cater for individual needs.”

Clinical Pharmacy Practice module: The School of Pharmacy & Pharmaceutical Sciences, Trinity College Dublin is now open to applications for the September 2017 intake of the Cardiology in Clinical Pharmacy Practice module http://pharmacy.tcd.ie/postgraduate/cardiology_clin_pharm_mod.php. The module is open to registered pharmacists working in ommunity practice. The course entails 12 weeks engagement, predominantly online, and will carry 5 credits under the European Credit Transfer and Accumulation System (ECTS). Closing date for applications: 30th June 2017. Application forms and additional information are available from Niamh McMahon, Course Coordinator, email cardioclinpharm@tcd. ie; or Marian Cash, Executive Officer, cashm@tcd.ie, Ph. 01-8963181 or 01-8963736 (Mon/Wed/Thurs am).

Pharmacists welcome end to ‘two-tier system’ Pharmacists have welcomed the announcement that patients will now have access to emergency contraception without prescription through their medical card. The move follows calls by the IPU to end the two-tier system in place for access to the emergency contraception.

less unplanned pregnancies. It was definitely a two-tier system previously, and unfair on people who use the medical card.”

The announcement was made by Minister for Health Simon Harris, at the annual meeting of the Irish Pharmacy Union in Dublin.

Pharmacies have been allowed to supply the “morning after pill” without a prescription since 2011

Speaking to Irish Pharmacy News, pharmacist Brian Kearney said, “This is a great move. Now that the morning after pill is available to medical holders, we can expect an increase in compliance, meaning

Previously, the Irish Pharmacy Union claimed the HSE is discriminated against women with medical cards, when it comes to accessing the “morning-after pill”. Prior to the move, women with medical cards still had to get a GP

prescription to get the medicine free-of-charge. This meant that one on five women who could access it free were nonetheless willing to go directly to the pharmacist and pay for it. The pharmacists argued it was not fair that a medicine that is known to be most effective the earlier it is taken could not be accessed immediately free of charge by medical card holders.


News Doubts expressed over Minor Ailment Scheme promotion The HSE’s commitment to the Minor Ailment Scheme (MAS) has been questioned by a pharmacist involved in the project. The Minor Ailment Scheme was piloted across 19 pharmacies in four towns, (Kells, Roscommon, Macroom and Edenderry) for three months. The Scheme allowed medical card holders to receive treatment for a list of common illnesses (Dry Eye, Dry Skin, Scabies, Threadworms and Vaginal Thrush) directly from their local community pharmacy in a timely manner and without the need for a visit to the GP. One pharmacist involved in the pilot scheme, who did not wish to be named, told IPN that they didn’t believe the Scheme was adequately promoted by the HSE. “While the MAS was a good scheme and still has merit and I believe it can work, none of

the public heard of it or knew it existed so it didn’t really take off,” according to the pharmacist.

The report on the Scheme is due to be completed by the end of June, according to the HSE.

“The doctors didn’t refer anyone on as far as I can tell so I do not know how much faith they had in it.”

Speaking at the launch of the pilot, Minister for Health Simon Harris TD said: “I am very pleased to welcome the launch of this pilot for a minor ailments service, which has been developed by the HSE and the Irish Pharmacy Union. Research commissioned by my Department from the Health Research Board has identified a wide range of similar services in other jurisdictions, with varying degrees of success. This pilot scheme is a great opportunity to establish if there is a demand for such a programme and how it might benefit Irish patients.”

The pharmacist also questioned the medications for conjunctivitis and vaginal thrush used through the Scheme. They said that the HSE really has to get behind the Scheme and make the public aware of it if the initiative is going to succeed. Following the completion of the pilot the HSE has liaised with the Health Research Board (HRB) and is finalising a report on the pilot project, which will include the HRB observations.

Shortage of young Pharmacists highlighted The shortage of qualified young pharmacists who wish to practise in community pharmacy has been highlighted as a major threat to the future of the sector the Irish Pharmacy Union (IPU). In the UK, the role of the pharmacist extends far beyond the scope allowed in Ireland, with pharmacists allowed to prescribe for minor ailments. In Canada, the scope of practice has been extended to include monitoring patients with chronic illnesses, and renewing and adjusting their prescriptions.

news brief CHILDHOOD OBESITY AN ONGOING PROBLEM The Health Service Executive in conjunction with the National Nutrition Surveillance Centre in UCD has published the Childhood Obesity Surveillance Initiative (COSI) in the Republic of Ireland. While the latest results from Childhood Obesity Surveillance Initiative (COSI) in Ireland show that levels of excess weight in children are stabilising they also indicate that:  at least one in five children* are overweight or obese;  more girls than boys are overweight or obese across all ages; and  those attending DEIS schools tend to have higher levels of overweight and obesity and the gap becomes wider as children get older. The report provides a picture of the height, weight and BMI in primary school aged children in Ireland currently as well as the trends over time since 2008. It will be repeated at intervals over the lifetime of the policy and will provide valuable information to policymakers and practitioners. Commenting on the findings Sarah O’Brien, HSE National Lead for the Healthy Eating Active Living Programme said “While it is positive that the levels of excess weight in children appears to be levelling off over time, it remains at quite a high level – with at least one in five children carrying excess weight that will damage their health both now and into the future.

The comments were made by Caitriona O’ Riodan, at the Irish Pharmacy Union (IPU) National Pharmacy Conference. Speaking at the Conference, O’ Riordan said, “There is evidence that young qualified pharmacists are either not entering community pharmacy or are leaving the profession, with many deciding to pursue careers in other areas. The reasons for this are varied but we know that one major offputting factor is excessive and increasing levels of administration and bureaucracy, coupled with a perception that their professional skills are underutilised in comparison to their colleagues in other countries.”

not properly utilised by a system that fails to recognise them. They seek more rewarding careers in other settings. This problem will, if not addressed, have serious ramifications, not just for community pharmacy, but for the wider community,” Ms O’Riordan said.

“Community practice is no longer attractive to young pharmacy graduates, who are frustrated that their knowledge and skills are

To make the sector more attractive, and professionally rewarding, it is essential that we allow pharmacists to expand their

Caitriona O'Riordan, Pharmacist, Cork

scope of services and ensure that they can practise their chosen profession rather than act as outsourced bureaucrats. “The last thing we want is to see, due to a lack of qualified staff, is our smaller villages and towns losing their local pharmacy, particularly when we see that happening already with other healthcare professionals including GPs and community nurses,” she noted.

“The findings indicate that we still have a significant way to go in creating environments in our homes, schools and communities where every child has the potential to grow and develop healthily from birth into adulthood. “The ten steps forward in the Healthy Weight for Ireland: Obesity Policy and Action Plan require action across a multiple.”

5


News Patrick McCormack to step down as news brief MD of Sam McCauley’s IRELAND DISCUSSED BREXIT CONCERNS Minister Simon Harris has welcomed EU Commissioner for Health and Food Safety, Vytenis Andriukaitis, to Leinster House for a meeting to discuss health issues of significance for Ireland and for Europe. Minister Harris raised Ireland’s overall concerns and priorities in relation to Brexit with Commissioner Andriukaitis and discussed the implications of Brexit for the health sector. The Minister reiterated Ireland’s commitment to membership of the EU and to maintaining a united approach among the 27 EU Member States when negotiations get underway. He also outlined the advantages that Dublin offers as a location for the European Medicines Agency in terms of sustainability and minimising disruption when it moves from London. Minister Harris and Commissioner Andriukaitis discussed how European countries can work together to ensure that patients are able to secure access to new and innovative drug treatments at an affordable price. They also discussed European Reference Networks that allow countries to pool together international expertise on rare diseases for the benefit of patients, and how best to combat the threat of anti-microbial resistance (AMR) including the fact that Ireland is finalising its first interdepartmental National Action Plan on AMR with a ‘One Health’ approach. Speaking after the meeting, Minister Harris said, “All of our work relating to Brexit’s impact on the health sector is informed by the following key priorities – to ensure continuity in the provision of health services and to avoid any changes to the current situation that would have a negative impact on human health. In this context, we had a useful discussion on health issues, and I look forward to engaging further with the Commission and other EU Member States on these issues in the future.”

6

Patrick McCormack will step down as Managing Director of Sam McCauley’s, following more than 25 years’ service, to pursue other business interests, it has been announced. Mr McCormack joined Sam McCauley’s as a pharmacist in 1991 and was appointed Managing Director in 2007. His tenure as Managing Director has seen the company expand store numbers nationwide and launch a successful online health and beauty offering. The move comes following the announcement that Carlyle Cardinal Ireland (CCI), the private equity fund established by The Carlyle Group (NASDAQ: CG) and Cardinal Capital Group, has agreed an investment in Sam McCauley Chemists Limited, the independent retail pharmacy group. The investment, terms of which are not being disclosed, is expected to complete before the end of the summer. Tony McEntee, one of Ireland’s most experienced retailing executives, and the former CEO of Allcare Pharmacy Group and Finance Director of Lifestyle Sports, will join the company as CEO following the completion of the investment. CCI has been an active growth investor in the Irish market over the last three years. Sam McCauley Chemists Limited is the fund’s eighth investment and the fund continues to explore other investment opportunities.

Ian Daly, Cardinal Capital Group, Sam McCauley and Jonathan Cosgrave pictured at the investment announcement Current fund investments include The AA Ireland, Payzone, Carroll Cuisine, Lily O’Brien’s, General Secure Logistics Services (GSLS), Learning Pool and Abtran. Upon completion of the Sam McCauley investment, the CCI portfolio companies will employ more than 4,000 people across the island of Ireland. The investment is subject to approval from the Competition and Consumer Protection Commission (CCPC). Sam McCauley, said “The health and well-being of our customers is at the heart of everything we do at Sam McCauley’s. We have maintained that customer focus

and high degree of service as the business expanded in size over the years through a continuous focus on introducing new products and services. The investment from CCI allows us to continue this growth as an Irish-owned business and will accelerate future innovations for the benefit of our customers and for the development of our loyal employees. I thank Patrick for his commitment, dedication and long service to the business, and for the significant growth that the company achieved under his leadership. I look forward to working with Tony and CCI during this exciting next stage in the company’s evolution”.

93% support pharmacists providing more services A survey has found that overwhelming public support pharmacists providing more services, with 93% of people saying they would like to see the pharmacy “offering services such as blood pressure or cholesterol testing at the pharmacy for a reasonable cost”. The findings come from a representative nationwide survey of 1,014 adults conducted by Behaviour & Attitudes, Ireland’s leading independent market research agency, from 13 March to 5 April this year. Meanwhile, 96% said they “would be in favour of the pharmacist being able to prescribe some medicines for minor ailments”. The Minor Ailment Scheme is an extended pharmacy service, which allows pharmacists to improve public health access and broaden pharmacy roles. Last month, IPN reported that Pharmacists are awaiting the publication of data currently

being analysed by the HSE, which analysed the effectiveness of a minor ailments scheme, which was tried in several pharmacies in Roscommon last year.

regarded as “easy to talk to about healthcare problems or issues” by 78% of the public.

In addition, 83% of respondents also score pharmacists very highly for being “capable of managing day-to-day healthcare issues I may have”.

The accessibility of pharmacists also scores very highly with the general public, with 90% saying they are “available at a time that suits me” (GPs get a score of 42% on this question). 98% of those surveyed said they “trust the advice and patient care” they receive from the pharmacist, and 96% say they “value the professional advice” they receive.

The healthcare services provided by community pharmacists are regarded as “very accessible” by 93% of people; represent “good value for money” in the opinion of 86% and pharmacists are

Nearly two-thirds of respondents (62%) said they “sometimes rely on a pharmacist’s advice rather than visiting the GP”, while 60% are “more likely to talk to a pharmacist first before visiting a GP”.

The HSE is yet to give any indication as to when the data will be published.


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Zirtek IE

Please consult the Summary of Product Characteristics before prescribing, information about this product can be found at www.medicines.ie Further information is available on request from UCB Pharma Ireland Ltd, United Drug House, Magna Drive, Citywest Road, Dublin 24 MA Numbers:

Zirtek 1 mg/ml oral solution: PA 891/8/3, Zirtek Plus Decongestant 5/120mg Prolonged Release Tablets PA 891/8/1, Zirtek Tablets PA0891/008/005

Product licence holder:

UCB Pharma Limited Legal Category: OTC

Classification:

Zirtek tablets & oral solution: Cetirizine dihydrochloride Zirtek Plus Decongestant prolonged release tablets: Cetirizine dihydrochloride, Pseudoephedrine hydrochloride

Adverse events should be reported to the Health Products Authority at www.hpra.ie or via email to medsafety@hpre.ie Adverse events should also be reported to UCB Pharma Ireland Ltd via email UCBCares.IE@ucb.com

February 2017 UK/16ZI0052


News news brief STEPS IN NEURODEGENERATIVE DISEASES A team of international researchers are carrying out work which could lead to significant implications for understanding synthesis generally, and particularly in neurogenerative diseases such as Alzheimer’s and Parkinson’s. Led by Professor in Physics at Trinity, Martin Hegner, an Investigator in CRANN, the team has for the first time observed how proteins fold while being produced in real time. Professor Hegner’s work focuses on individual ribosomes, which are complex molecules that use genetic information to assemble proteins. There can be several million ribosomes in a typical human cell and they are about 20 nanometres in diameter. The assembly of proteins is crucial for a healthy functioning body as all the proteins in our bodies must fold into complex shapes to do their job. While protein synthesis is of fundamental importance in cellular processes, how they are created is not fully understood. One of the events that occurs during protein synthesis is “folding”, where the chains of amino acids (polypeptides) fold into their final 3-dimensional structures. Several neurodegenerative diseases (such as Alzheimer’s) and many allergies are believed to result from misfolded proteins. This research is thus important in developing further understanding of such conditions and in developing drugs that can target and prevent certain foldings. There has been interest expressed in Professor Hegner’s work by pharmaceutical companies. Professor Hegner said, “We have identified key mechanisms within individual ribosomes using our unique optical tweezer instrumentation, of which there are only approximately five world-wide. Our expertise in the design of the device and the biological experiment, along with colleagues in Germany enabled us to “grab” the ribosome and the nascent protein chain and provided sufficient stability and sensitivity to observe the synthesis and folding of single polypeptides in real time at the nanometer scale.”

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How Pharmacists can reduce GP workload Integrating pharmacists into General Practice could help relieve doctors’ workloads and improve prescription safety, a study has confirmed. The study at the University of Sunderland concluded that integration of pharmacists in general practice can reduce GP workload, improve prescribing safety, and improve medicines optimisation. The research, funded by Pharmacy Research (PRUK), explored the attitudes and perceptions of GPs to pharmacist-led care in general practice, identifying potential barriers and the channels to the integration of pharmacists in the service. Barriers to integration Negative professional attitudes and a lack of confidence in pharmacists’ clinical aptitude were thought to be potential barriers to the integration of pharmacists in this setting; however, it is thought that this can be overcome by team work and being jointly located, as well as further pharmacist training. This study provides insight into the attitudes and perceptions of GPs to pharmacist led care in general practice. The findings demonstrate the perceived benefits of the integration of pharmacists, the scope of practice as well as the perceived barriers and facilitators to the integration of pharmacists’ in general practice. Academic Practitioner Tahmina said, “There are a lot of perceptions about pharmacist led care in general practice, from the work they should be doing to whether GPs actually want them there. My research was about capturing the views of GPs and focusing on exactly what they want. “One of those areas was improving medicines optimisation - ensuring patients are making the best use of their medicines, minimising side effects from medication as well as preventing potential waste of NHS resources.” In particular pharmacist independent prescribers were perceived to have a wider scope of practice and a greater impact on workload pressures. Scott Wilkes part-time GP Principal at Coquet Medical Group in Northumberland and a Professor of General Practice and Primary Care at the University of Sunderland, commented, “Tahmina’s Masters project has given some unique insights into the attitudes and perceptions of GPs towards pharmacist led care in general practice. “Among the key messages to come out were the desire of GPs

Scott Wilkes part-time GP Principal at Coquet Medical Group in Northumberland, Professor of General Practice and Primary Care at the University of Sunderland,

to have pharmacists in general practice in patient-facing NHS roles helping to meet the demands of the general population. “However, GPs still lack clarity on the ability and the role which pharmacists could fulfil in general practice. I suspect this finding will also be shown in the evaluation of the national programme where pharmacists are employed in general practices throughout the UK but deployed in a number of different ways.” Irish Pharmacists Such barriers, while present in the UK, also present problems for pharmacists in Ireland. Last year, the Pharmaceutical Society of Ireland called for an expanded role for Irish Pharmacists in the context of the Irish healthcare system in its Future in Pharmacy report. The report called for Pharmacists in particular to have an expanded role in terms of contributing to health and wellbeing initiatives through structured population health information and awareness campaigns and preventative medicine to support the maintenance and improvement of the health of the public; as well as providing expertise in assisting patients to manage their

chronic diseases and medication through structured initiatives and, where appropriate, through supplementary prescribing in collaboration with a patient’s GP. The PSI also called for pharmacists to have an increased role in terms of managing medicines throughout the patient care pathway via structured initiatives such as medication reviews for at-risk and vulnerable patients in the community and local settings e.g. nursing homes; and the greater presence of pharmacy throughout the patient pathway in acute settings, reducing prescribing errors and optimising the impact of medicines for patients. Meanwhile, the IPU has also called for an expanded role for Irish pharmacists, calling for an extended vaccinations programme to be rolled out nationwide, along with a minor ailments scheme, which would empower pharmacists to treat common ailments, such as Dry Eye, Dry Skin, Scabies, Threadworms and Vaginal Thrush. Last year, a minor ailments scheme was piloted in Kells, Roscommon, Macroom and Edenderry. Pharmacists are currently awaiting a report from the Department of Health regarding the results of the pilot, in addition to any future plans to extend the scheme.


IPU Conference

IPU President calls for national Minor Ailment Scheme The President of the Irish Pharmacy Union (IPU) Daragh Connolly has called for a Minor Ailment Scheme in pharmacies nationwide. “We want to see the Minor Ailment Scheme – which was successfully piloted last year by the IPU and the HSE – rolled out nationally, so that medical card holders can get treatment for specified minor conditions directly from their pharmacist,” he said. The comment was made in his opening address to the Irish Pharmacy Union’s National Pharmacy Conference in Croke Park on May 5th. He added that these were examples of the real public benefit that results from modernising how healthcare is delivered and promoted through pharmacies. Mr Connolly also criticised the failure of the Government to honour a clear commitment to begin unwinding the disproportionate burden of payment cuts on pharmacists under the FEMPI legislation. “No other healthcare profession has had to endure cuts in the region of ¤2.6 billion in the last eight years, through a combination of reduced reimbursement prices for medicines, repeated cuts to pharmacy margins and significant cuts to pharmacists’ direct remuneration – fee reductions and elimination of mark-ups on Statefunded schemes,” he said. At the same time, Mr Connolly said pharmacists were being buried under an ever-increasing burden of regulatory and administrative demands, while having to pay among the highest pharmacy registration fees in the world. In comparison to other professionals providing services on behalf of the HSE, and other similar groups in receipt of State payments, pharmacists had been hugely and disproportionately impacted by the FEMPI legislation from the outset. “We welcomed the clear commitment of the previous Minister to commence the unwinding of the savage reductions in payments to community pharmacy contractors, which were introduced under the

Health Minister Simon Harris addresses the conference

FEMPI Act. However, to date, we have failed to see one cent returned. This is completely intolerable and unacceptable to our members. Pharmacists expect equitable treatment and that Government will keep its word; nothing more, nothing less. “Acknowledging receipt of a letter from the Department of Health the previous evening on this issue he hoped that this was an indication of the Minister’s intention to make genuine progress on this matter”. The IPU President said his organisation strongly supported the Department of Health’s policy statement promising “a decisive shift towards primary care in the delivery of health services in Ireland, which may be seen as a core component in the development of a more integrated health service”, and added

that the network of community pharmacies, employing over 20,000 staff nationwide, could play a vital role in delivering this model of healthcare. “The pharmacist is often the only healthcare professional immediately accessible to people in their own communities. At a time when many villages and small towns around the country no longer have a bank, a Garda station, a post office or, in some cases, a GP service, local pharmacies remain a vital cornerstone of that community”. He referenced the recommendations of the Joint Oireachtas Committee on Health and Children in 2015 to expand the role of the pharmacist, and the Pharmaceutical Society of Ireland’s report, ‘Future of

Pharmacy Healthcare – Meeting Patients’ Needs’, published recently, which concluded that the only affordable solution to meeting increased patient demands was through a multi-disciplinary approach to healthcare, where the highest quality of care was delivered as close to the patient’s home as possible. “A critical part of the delivery of this care is through the utilisation of the skills and accessibility of community pharmacists,” the IPU President said. Citing data from the research company Behaviour & Attitudes, which found that more than 9 in 10 pharmacy users believed that the pharmacy was a good place to make more healthcare services available, and wanted to see

9


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IPU Conference

Corr's Pharmacy Pharmacist John Corr

Former Pharmaceutical Society President John Fahey, Fahey's Haven Pharmacy, Tullamore

IPU President Darragh and Health Minister Simon Harris

Mr Fergus Brennan, Brennan's Pharmacy, Buncrana

the range of services provided by community pharmacists expanded, he said that there was a clear public demand “for better availability of primary healthcare services in the community, and the solution to filling that gap can come from community pharmacy”. And there was compelling international evidence and experience to show that providing community pharmacists with a greater role benefits people’s health outcomes and the healthcare systems themselves. “Community pharmacists are enthusiastic to do more, to manage patients as well as dispense prescriptions, and we should help them to do more – to manage minor ailments, administer more vaccines, and do more medicine management and monitoring.”

Mr Connolly said that pharmacists did not want to replace GPs or other healthcare professionals. “We simply want to complement their services and use our expertise for the benefit of our communities. We want to allow under-pressure GPs to concentrate on diagnosis and on treating patients with more serious conditions. The evidence confirms that providing these additional pharmacy services has resulted in better health outcomes for patients, with fewer unscheduled GP visits, fewer hospital admissions and a reduction in mortality.” In pursuit of a broader self-care agenda, the IPU has long advocated that a wider range of safe and effective treatments be made available without prescription.

Emer Begley, Senior Project Manager, National Dementia Office, HSE

“We would like to see the list extended to include, for example, sumatriptan for migraine, newer anti-allergy medicines like fexofenadine and a wider range

of analgesics, which are already available without prescription in the UK and elsewhere. Why are Irish patients and consumers forced to get prescriptions for

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IPU Conference “We are delighted that, thanks to this Minister’s action, women who hold medical cards will soon have appropriate access to emergency contraception in pharmacies, as private patients already can, without having to make an unnecessary trip to the GP.

“Pharmacists should be at the vanguard of this changing approach. We already provide opiate substitution using methadone; we provide needle exchange services in areas of need; we provide a crucial point of contact with healthcare for those whose problems have made them outsiders in our society. We want to do more,” he said.

Illegal drugs possession motion

Seconding the Motion

Possession of small amounts of illegal drugs for personal use should be treated as a health problem rather than a criminal issue, the Mr Connolly, told the National Pharmacy Conference.

Seconding the motion, Ms Kathy Maher, former IPU President and a community pharmacist in Duleek, Co. Meath, welcomed the recommendations of the Joint Committee on Justice, Defence and Equality in its Report of the Committee on a Harm Reducing and Rehabilitative Approach to Possession of Small Amounts of Illegal Drugs, published in November 2015.

medicines which should not require a prescription?

He said that people with drug problems should be given the same level of care as people with other health issues. Proposing a motion to this effect, he said that “addressing the drug problem in Ireland is a balancing act between preventing illicit use of drugs and associated health problems and ensuring access to treatment for those addicted to drugs. The World Health Organisation has acknowledged that people with drug disorders deserve the same level of care as patients with any other health condition. Health services need to be able to identify drug use and drug use disorders at an early stage and provide prevention, treatment and harm reduction interventions.” Mr Connolly said that, for people who are not yet dependent on drugs, efforts should focus on preventing dependence and reducing the harm associated with drug use. “For people suffering from drug dependence, health systems have to provide access to comprehensive treatment, including psychosocial support, pharmacotherapy and the prevention and management of associated health problems such as HIV, tuberculosis, viral hepatitis, mental health disorders and drug overdose.” He said he welcomed the recent enactment of the Misuse of Drugs (Supervised Injecting Facilities) Act to provide for the establishment, licensing, operation and regulation of supervised injecting facilities for the purposes of reducing harm to people who inject drugs; to enhance the dignity, health and wellbeing of people who inject drugs in public places; to reduce the incidence of drug injection and drug-related litter in public places and, thereby, to enhance the public amenity for the wider community.

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She said that the committee had suggested “that a health/ counselling/treatment approach may be more effective and more appropriate for those found in possession of a small amount of illegal drugs for personal use, rather than imposing a criminal sanction resulting in a lifelong criminal record. The committee pointed out that better use would be made of Garda and court resources if, in certain cases, a criminal sanction was not mandatory for possession of small amounts of drugs for personal use.” She said that Portugal had adopted this policy 15 years ago and “has seen the harm reducing benefits of this approach, such as an increase in the numbers of people who misuse drugs seeking help for their addiction, a fall in the number of HIV/AIDS cases and significant savings in law enforcement and court service resources. While it is still an offence in Portugal to possess illegal drugs, if the person is found with 10 days’ supply or less for personal use, they can be required to report to a Committee for Addiction Dissuasion, where an assessment is carried out and education/treatment provided or, in some cases, a return to the criminal justice system can result.” Ms Maher said that discretion should remain with An Garda Síochána as to whether a civil/ administrative response or a criminal sanction was appropriate. “Indeed, the Oireachtas Committee acknowledged that no single treatment approach is effective for all persons and the harm reducing and rehabilitative approach must be flexible and

Former IPU President Kathy Maher, Maher's Haven Pharmacy

appropriately resourced to cater for individual needs.”

better patient outcomes in any development.

Minister Harris outlines priorities

“The second point is that our priority must be on services where the public health needs are not addressed elsewhere, or on services that could be demonstrably better delivered by community Pharmacy provision, through, among other things, better access, better health outcomes or better value for money.

In delivering his keynote address, Health Minister Simon Harris said the theme of the conference ‘reflects a principle that many of you have heard me talk about consistently – that we need a decisive shift of health services to primary care, to deliver better care close to patients and their home communities.’ “I want Irish patients to be able to get safe and clinically effective treatments early, at the lowest level of complexity and as close to their homes as possible. Community Pharmacy has a core role to play in addressing health needs in this way, for both private and public health services,” he said. “We are very keen, as I have said on more than one occasion, to expand community Pharmacy services to our patients, particularly with the challenges we are facing, such as an aging population, the need for earlier hospital discharge and the increasing range of communitydelivered treatment. “This is something we are all very interested in. However, there are two points we must recognise. The first is that the provision of community Pharmacy services on behalf of the HSE is primarily a contracted service. Irish pharmacy services have always been provided through private contractors and this has served us very well – but it does mean that service expansion, for public patients, has significant implications for limited health resources. Accordingly, there must be a measurable element of

“With these caveats, expansion of community Pharmacy services will be a cornerstone of any structured shift to greater primary care provision. You are the medicines experts and we need to harness your expertise. “However, in doing this we must not lose focus on the core function of community Pharmacy – the dispensing of medicines to patients in a safe and professional environment. “We need a long term vision for Irish healthcare. That vision needs political and societal consensus and it should not change with a change in Government. “A key commitment in the Programme for Partnership Government is the development of this vision over a 10 year period, through cross party consensus. The Future Healthcare Committee, chaired by Deputy Róisín Shortall, has been considering this vision and the direction of health policy, the implications of projected demand, a preferred care model and how to achieve and fund this. “I have recently met with the Committee and I am confident that primary care, and the enhancement of it which we all wish to see, will be key to its recommendations.”


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News Over ¤14,000 for Hugh’s House raised at the news brief 2017 Irish Pharmacy Awards! MCI AND PSI IN JOINT SAFETY INITIATIVE

Irish Pharmacy News nominated charity for 2017 is the extremely worthwhile cause of Hugh’s House. long term inpatients of Temple Street and the Rotunda Hospitals. Opened in May 2015, the charity is located less than 5 minutes walk from both hospitals, both of which manage the referrals to the house.

The Medical Council of Ireland and the Pharmaceutical Society of Ireland (PSI) have come together, in a joint initiative, to examine patient safety matters of mutual concern and to make available practical guidance on the safe prescribing and dispensing of medicines that will be of use to both the medical and pharmacist professions. The first joint guide is on the Safe Prescribing and Dispensing of Controlled Drugs and the PSI would like to receive feedback on it from pharmacists, doctors and others prior to its finalisation. As the use of medication is the most frequent intervention in healthcare systems, it is considered to be a critical component of patient care, but also one of high risk. This resource is intended for use by all medical doctors and pharmacists in the collaborative, safe and effective care of patients, to facilitate safer prescribing and dispensing of controlled drugs (CDs), and with a particular focus on Controlled drugs in Schedule 2, 3 and Schedule 4 Part 1. This includes reference to changes made by the recent Misuse of Drugs Regulations 2017, and sample prescriptions are also included. The final guidance will be made available both by the PSI and the Medical Council.

Ade Stack, Hugh's House Founder, Stacks Pharmacy Group

At the 2017 Irish Pharmacy Awards, we specially commissioned our own scratch cards, in association with Fitzgerald Power in order to raise money for the charity, set up by Stacks Pharmacy Proprietor Ade Stack and her husband and were thrilled to have raised an exceptional amount, totalling over ¤14,000! Hugh’s House provides accommodation 365 days a year to the family of children who are

When their baby son Hugh was ill in hospital, Ade Stack and Marty Curley were thankful they lived in Dublin. They witnessed the struggles of other families travelling from all over the country to visit their sick children, some of whom were unable to cope financially with the expense of accommodation and meals. They were devastated when they saw children, especially babies who rarely had visitors because their families lived too far away. Families are under severe pressure with a very ill child being separated at a time when they needed each other the most. When a child is in hospital, no one can cheer them up or excite them as much as their brothers and sisters. They wanted a place for children who face long journeys for outpatient appointments to have a place to go before they face the long journey home. Ade gave an inspirational talk at the Awards to a standing ovation and inspired those who attended to dig deep. Allcare Pharmacies

Pharmacists are invited to read the draft guidance document and give feedback through an online consultation survey by close of business on Friday, 2 June 2017. It also provides the option to suggest other matters for the PSI/Medical Council group to address through its future work or joint guidance. The Pharmaceutical Society of Ireland (PSI) carries out regular public consultations so that the opinion and input of stakeholders is considered in the work being undertaken. Through it’s consultations, it seeks to achieve an understanding of what is important to the general public, and to those working in Pharmacy.

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David Power, Noel Winters, Stuart Fitzgerald and Maurice Fitzgerald, Fitzgerald Power

Hugh’s house

alone donated ¤3000 alongside a further ¤2000 in stock – a tremendous donation from the team! Hugh’s House provide them a space to spend time as a family, to play, to live and eat together. Volunteers are on hand to help nourish the families with homecooked food to strength them. Take away food will not sustain families long-term so we want to provide a nutritious dinner through volunteer cooks. Stuart Fitzgerald, of Fitzgerald Power who supported the Scratch Cards said, “Hugh’s House is a fantastic initiative which Fitzgerald Power are very proud to support. We have huge admiration for the great work undertaken by Ade and the Hugh’s House volunteers to help the families of very ill children. We are delighted to hear that more than ¤14,000 was raised at the Irish Pharmacy Awards to support this important work.”


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News news brief HSE LOSES ¤56M BY NOT IMPLEMENTING POLICY Ahead of European Obesity Day IrSPEN (Irish Society for Clinical Nutrition & Metabolism) has launched Obesity is a Chronic Disease requiring Treatment: A Call to Action. Obesity experts are calling on the government to implement a national obesity treatment programme to reduce the financial and societal burden from obesity-related diseases like type 2 diabetes, heart disease, sleep apnoea, cancer and fertility issues. By recognising obesity as a disease of the brain and treating people with personalised treatment programmes, including diet, exercise, weight loss medicine, cognitive behavioural therapy, and surgery the HSE could have saved millions. For example, doing a minimum of 400 operations per year on patients with obesity and difficult to control diabetes would have saved ¤56 million over a 10year period from a reduction in diabetes medication costs alone. * This call to action is supported by The Royal College of Physicians in Ireland (RCPI) and The European Association for the Study of Obesity (EASO). According to the WHO, 65% of the diabetes burden, 23% of the heart disease burden and between 7% and 41% of certain cancer burdens are attributable to overweight and obesity. The current cost of treating obesity-related diseases here is approximately ¤1.16 billion per annum: 35% of this cost is allocated to hospital care and medication costs and 65% is from indirect costs including productivity losses from absenteeism. The obesity call to action, supported by European and Irish expert bodies and patient organisations, urges immediate and decisive government action to address the gaps in our healthcare system that prevent those affected by the complications of obesity from accessing effective therapies that will help them achieve and sustain more than 10% loss in body weight.

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Changes to phased dispensing arrangements The HSE has issued enhanced validated arrangements for the submission of phased dispensing claims by pharmacists. The change in arrangements was made by the HSE, with the agreement of the Department of Health, as a result of the increase in phased dispensing claims in recent years. From the beginning of May, prior approval for phased dispensing claims is necessary for all newly initiated phased dispensing patients for subsequent reimbursement claims to be paid. On the PCRS Pharmacy Application Suite, from 1 May 2017, pharmacies will find Phased Dispensing Approval Request screens for completion. For phased dispensing fees to be payable in respect of newly initiated patients, pharmacy users must first enter a valid medical card number and identify the reason that the patient requires a phased dispensing service. This must be done prior to providing a phased dispensing service to the patient.

Where the GP has made a request to the dispensing pharmacy by inserting the words phased dispensing on the face of the prescription, it should be selected that this method of dispensing was requested by the patient’s physician, with a copy of the GP prescription displaying the doctor’s instruction for phased dispensing scanned or photographed and attached on the application suite before submission. In exceptional circumstances where the patient is incapable of safely and effectively managing their medication regimen, it remains available for the pharmacist to make that determination as a sole practitioner. Where the following criteria can be confirmed, it is highly likely that the patient will be approved in a very short timeframe: Patient is over 80 years; patient is on one or more psychotropic medicines (with the five digit codes of the relevant medicines

provided); patient is on five or more oral medicines in a month; PSI Registration of Pharmacist conducting the assessment; and date of pharmacist assessment of patient If one or more of the above confirmations cannot be provided, the application will require further assessment and it may be 24 hours (Monday to Friday, or the first working day after a weekend) before approval or non-approval will be communicated back to the pharmacy by the PCRS through the application suite. While the application is under consideration, pending will be displayed on the screen. Similar functionality will be made available to GPs if they wish to enrol patients for phased dispensing services without writing phased dispensing on the face of the prescription. Where a GP completes the application, it will be automatically approved and contemporaneously visible on the pharmacy application suite for that patient as ‘approved’.

Pharmacists encouraged to help with inhaler technique Pharmacists are being called to help patients with inhaler technique, following the announcement from the Asthma Society of Ireland that up to 300,000 Irish asthmatics are not using their inhalers correctly, leaving them at risk of a serious asthma attack and even death. 470,000 Irish people have asthma, including one in five children, one Irish person dies every week as a result of an asthma attack, 90 per cent of which are preventable

The Asthma Society has also recently launched a TV advert and social media campaign featuring the father of a teenager who died from an asthma attack.

According to Irish Asthma Society, the key points for Pharmacists to get across patients with Asthma are: When to use the inhaler; how to use the inhaler; the difference between relievers and controllers; what side effects to look out for and how to minimise them

Chris Martin was a fit and healthy nineteen year old and played rugby for University College Cork. His dad Michael says in the ad, “I never thought asthma would kill Chris. I never thought it would kill anyone.”

Pharmacists should encourage patients to bring their inhalers with them at every visit and offer to check technique each time, reinforcing the point that “perfect practice makes perfect.” CEO of the Asthma Society of Ireland, Averil Power, said “Up to 60% of all asthmatics don’t use their inhalers correctly and so don’t have their asthma under control. “As a result, someone ends up in A&E every 26 minutes with a serious asthma attack and 50 people die each year from the condition. Tragically, the vast majority of these deaths could be prevented through proper asthma management.”

“Unfortunately, Michael’s story is not unique”, said Averil. “It is very important everyone with asthma realises their condition can potentially be serious and takes their preventative medicine as prescribed, even when they are feeling well.” The Asthma Society has set up a special fundraising appeal in memory of Chris Martin. His dad Michael is asking people to support it by going to the donate page. “With your support, the Asthma Society will help other young people like Chris manage their asthma better and spare other families the pain of losing a child to asthma,” he said. Averil concluded by thanking GSK

Averil Power, CEO, Asthma Society of Ireland

for supporting the campaign. “GSK’s funding for this awareness campaign means all the proceeds raised from the Chris Martin Appeal will go towards the Asthma Society’s education and advocacy work”, she said.


Abbreviated Prescribing Information Abbreviated Prescribing Information Nurofen Express 200mg Tablets Nurofen Express 200mg Tablets Nurofen Express Maximum Strength 400mgTablets Tablets Nurofen Express Maximum Strength 400mg Abbreviated Prescribing Information Refer Summary of Product Characteristicsfor forfull fullinformation information Refer toto Summary Product Characteristics Nurofen Express of 200mg Tablets Active ingredient: Ibuprofen (as sodiumdihydrate). dihydrate).Pharmaceutical Pharmaceutical Form:Coated Coatedtablet tablet- -white whiteto tooff-white, off-white,bioconvex, bioconvex, round, round, sugar sugar coated tablet with an identifying logo black and red (for Active ingredient: (as sodium identifying logo in in400mg black(for (for200mg 200mgtablet) tablet) redface. (for400mg 400mgtablet) tablet)on onone oneface. face. Nurofen ExpressIbuprofen Maximum Strength 400mg Tablets hite to off-white, bioconvex, round, sugar coatedForm: tablet with an identifying logo in black (for 200mg tablet) and red (for tablet) on and one Indications: anti-inflammatory, analgesicand andantipyretic antipyreticfor forshort-term short-termmanagement managementofofmild mildto tomoderate moderatepain painsuch suchas as isis associated associated with headache, dental pain, period pain, muscular strain, and for the of the of head colds and influenza. Dosage & Indications: anti-inflammatory, analgesic pain, fever, fever,and period pain, muscular strain,backache, backache, forsymptoms themanagement management thesymptoms symptoms head colds and influenza. Dosage to Summary of Product for full information d to Refer moderate pain suchCharacteristics as is associated with headache, dental pain, fever, period pain, muscular strain, backache, for the management ofand the ofofhead colds of and influenza. Dosage && Administration: oral administration.Short Shortterm termuse useonly. only.Adults Adultsand andchildren childrenover over12 12 years: Nurofen NurofenExpress Express200mg 200mgTablets: Tablets: 1-2 1-2 tablets every four hours with aa maximum of in hours, i.e. maximum dose ofof1200mg inina a2424hour period. Nurofen Express Maximum Strength ForFor oral administration. withmaximum maximum of6dose 6tablets tablets ina1200mg a24 24tablet) hours,and i.e. maximum dosetablet) 1200mg Nurofen Express Maximum Strength Active ingredient: Ibuprofen (as sodium dihydrate). Pharmaceutical Form: Coated tablet years: - white to a off-white, bioconvex, sugar coated with an identifying logo in black (for 200mg red on one face. hour period. ars:Administration: Nurofen Express 200mg Tablets: 1-2 tablets every four hours with maximum ofround, 6 tablets in a tablet 24 hours, i.e. of in a(for 24400mg hour period. Nurofen Express Maximum Strength 400mg Tablets; ONLY 1 TABLET PER DOSE.1 1tablet tabletevery everyfour fourhours hourswith withaamaximum maximumofof33tablets tabletsininaa24 24hours, hours,i.e. i.e.maximum maximum dose dose of 1200mg in a 24 hour period. Max duration of treatment 33days. IfIfthe symptoms worsen you should consult a adoctor. If Ifinin adolescents this medicinal product 400mg Tablets; ONLY 1 TABLET PER DOSE. period. Max duration of treatment days. the symptoms worsen you should consult doctor. adolescents this medicinal product anti-inflammatory, analgesic and antipyretic for short-term mild to moderate pain such as of is associated with headache, pain, fever, period pain, muscular strain, backache, and for theamanagement the symptoms of head colds and influenza.product Dosage & bletsIndications: in a 24 hours, i.e. maximum dose of 1200mg in management a 24 hourofperiod. Max duration treatment 3 days.dental If the symptoms worsen you should consult doctor. Ifofin adolescents this medicinal is required for more than 3 days symptomsworsen worsena adoctor doctorshould shouldbe beconsulted. consulted.Not Notsuitable suitablefor forchildren childrenunder under 12 12 years years of of age age without medical advice. Use NSAIDs with in elderly and at the dose ofofshortest period due totohigher risk ofof adverse drug reactions (ADRs). is required more 3administration. days oror if ifsymptoms Use NSAIDs withofcaution caution inthe the elderly and thelowest lowest dose shortest due higher risk adverse drug reactions (ADRs). Administration: Forthan oralunder Short of term use only. Adults and children advice. over 12 years: Nurofen Expresswith 200mgcaution Tablets: 1-2in tablets four hours maximum 6 tablets in a 24 hours, i.e.at maximum dose ofto 1200mg in aperiod 24 hour period. Nurofen Express Maximum Strength uitable for for children 12 years age without medical Use NSAIDs theevery elderly andwith at athe lowest dose of shortest period due higher risk of adverse drug reactions (ADRs). Discontinue if no benefit is seen or intoleranceoccurs. occurs.Contraindications: Contraindications:History Historyofofgastrointestinal gastrointestinalbleeding bleedingor or perforation related related to to previous previous NSAIDs NSAIDs therapy. Active or of peptic ulcer/haemorrhage (two or more distinct episodes ofofproven ulceration oror bleeding) or or Discontinue if no benefit is perforation seen or intolerance Active or history history ofrecurrent recurrent peptic ulcer/haemorrhage (two more distinct ulceration bleeding) 400mgbleeding Tablets; ONLY or 1 TABLET PER DOSE. 1related tablet every four hours with aNSAIDs maximum of 3 tablets inActive a 24 hours, maximumof dose of 1200mg inpeptic a 24 hourtherapy. period. Max duration of treatment If the symptoms worsen youor should aepisodes doctor. If inproven adolescents this medicinal product ntestinal to previous therapy. ori.e.perforation history recurrent ulcer/haemorrhage (two3 days. or more distinct episodes ofconsult proven ulceration or bleeding) or other gastrointestinal disorder. Patientswith witha aknown knownhistory historyofofhypersensitivity hypersensitivityreactions reactions(e.g. (e.g.asthma, asthma,bronchospasm, bronchospasm, rhinitis, rhinitis, angioedema angioedema or or urticaria) urticaria) in response to ibuprofen (the active substance) or any ofofthe excipients, acetylsalicylic acid (aspirin) oror other non-steroidal other gastrointestinal disorder. Patients in response to ibuprofen (the active substance) or any the excipients, acetylsalicylic acid (aspirin) other non-steroidal is required for more than 3 days or ifrhinitis, symptoms angioedema worsen a doctor should be consulted. in Notresponse suitable for children under 12 years of age withoutsubstance) medical advice. or Useany NSAIDs in the elderly and at the lowest dose shortest period to higher risk of adverse drug reactions (ADRs). e.g. asthma, bronchospasm, or urticaria) to ibuprofen (the active ofwith thecaution excipients, acetylsalicylic acidof(aspirin) or due other non-steroidal anti-inflammatory drugs (NSAIDs). Useininchildren childrenunder under1212years yearsofofage. age. Patientswith withsevere severehepatic hepaticfailure, failure,severe severerenal renal failure failure or or severe severe heart heart failure. failure. Patients with rare problems of intolerance, glucose-galactose malabsorption or sucrase-isomaltase insufficiency should anti-inflammatory (NSAIDs). Use Patients with rareorhereditary hereditary offructose fructose intolerance, glucose-galactose malabsorption sucrase-isomaltase insufficiency Discontinue if nodrugs benefit is seen or intolerance Contraindications: History ofPatients gastrointestinal bleeding or perforation related to previous therapy. Active historyglucose-galactose of problems recurrent peptic ulcer/haemorrhage (two or more episodes oforproven ulceration or bleeding) or should re hepatic failure, severe renal failureoccurs. or severe heart Patients failure. with rare hereditary problems ofNSAIDs fructose intolerance, malabsorption ordistinct sucrase-isomaltase insufficiency should take this medicine. During the lasttrimester trimesterofofpregnancy. pregnancy.Warnings Warningsand andPrecautions: Precautions:Undesirable Undesirableeffects effectsmay maybe be minimised minimised by by using using the the minimum minimum effective dose for the duration necessary to control symptoms. The an increased frequency ofof adverse reactions to notnot take this medicine. During the last effective theshortest shortest duration necessary control Theelderly elderlyhave have increased frequency adverse reactions other gastrointestinal disorder. Patients with a known history ofthe hypersensitivity reactions (e.g. asthma, bronchospasm, rhinitis, angioedema or urticaria) in response tofor ibuprofen (the active substance) or to any of have the symptoms. excipients, acetylsalicylic acidan(aspirin) orof other non-steroidal ndesirable effects may be minimised by using minimum effective dose for the shortest duration necessary todose control symptoms. The elderly an increased frequency adverse reactions toto NSAIDs especially gastrointestinal bleedingand andperforation perforationwhich whichmay maybe befatal. fatal.Prolonged Prolongeduse useof ofNSAIDs NSAIDsin inthe theelderly elderly isis not not recommended. recommended. Use Use with concomitant NSAIDs, including cyclooxygenase-2 selective inhibitors, should Increased risk ofof aseptic meningitis with especially gastrointestinal bleeding with Patients concomitant NSAIDs, including cyclooxygenase-2 selective inhibitors, shouldbe beavoided. avoided. risk aseptic meningitis anti-inflammatory drugselderly (NSAIDs). Use in children under 12 years of age. Patients severe hepatic failure, severe including renal failure or cyclooxygenase-2 severe heart failure. with rare hereditary problems of fructose intolerance, glucose-galactose malabsorption or sucrase-isomaltase insufficiency useNSAIDs of NSAIDs in the is not recommended. Use withwith concomitant NSAIDs, selective inhibitors, should be avoided. Increased risk of Increased aseptic meningitis with withshould Systemic lupus erythematosus and mixedconnective connectivetissue tissuedisease. disease.NSAIDs NSAIDsshould shouldbe begiven givenwith withcare careto topatients patientswith with aa history history of of gastrointestinal gastrointestinal disease (ulcerative colitis, Crohn’s disease) as their condition may be exacerbated. GIGIbleeding, ulceration oror perforation, which can bebe fatal, hashas Systemic lupus erythematosus and mixed disease (ulcerative colitis, Crohn’s disease) as their condition may be exacerbated. bleeding, ulceration perforation, which can fatal, not care take this During the last trimester of Warnings and Precautions: Undesirable effects may beCrohn’s minimiseddisease) by using theas minimum dose for the shortest duration necessary control symptoms. The elderlyor have an increased frequency of adverse reactions n with tomedicine. patients with a history ofpregnancy. gastrointestinal disease (ulcerative colitis, their effective condition may be exacerbated. GItobleeding, ulceration perforation, which can be fatal,to has been reported with all NSAIDs anytime timeduring duringtreatment, treatment,with withororwithout withoutany anywarning warningsymptoms symptomsor oraaprevious previoushistory history of of serious GI GI events. events. The The risk GI ulceration or isishigher increasing NSAID doses, in patients with a ahistory of ulcer, particularly if complicated been reported all NSAIDs atat any risk of of GI bleeding, bleeding, ulceration orperforation perforation higherwith with increasing NSAID doses, patients with history ulcer, particularly if complicated NSAIDs especially gastrointestinal bleeding and perforation which mayThe be fatal. Prolonged use of NSAIDs in the elderly is or notserious recommended. Use with concomitant NSAIDs, including cyclooxygenase-2 selective inhibitors, should bein avoided. Increased risk ofof aseptic meningitis with ymptoms or awith previous history of serious GI events. risk of GI bleeding, ulceration perforation is higher with increasing NSAID doses, in patients with a history of ulcer, particularly if complicated with haemorrhage perforation, andininthe theelderly. elderly.These Thesepatients patients shouldcommence commencetreatment treatmenton onthe thelowest lowestdose dose available. available. Combination Combination therapy therapy with protective agents (e.g. or proton pump should be for and also forfor patients requiring with haemorrhage oror perforation, and with (ulcerative protective agents (e.g.misoprostol misoprostol proton pumpinhibitors) inhibitors) should beconsidered considered forthese thesepatients, patients, and also patients requiring Systemic lupuslowest erythematosus mixed connective tissue disease.should NSAIDs should be given with care to agents patients with a history of gastrointestinal disease Crohn’s disease) asortheir may be exacerbated. GI bleeding, ulceration or perforation, which can be fatal, has tment on the doseand available. Combination therapy with protective (e.g. misoprostol or proton pumpcolitis, inhibitors) should becondition considered for these patients, and also for patients requiring concomitant low dose aspirin, otherdrugs drugslikely likelytotoincrease increasegastrointestinal gastrointestinalrisk. risk.Patients Patientswith withaahistory historyof ofGI GItoxicity, toxicity, particularly particularly when when elderly, elderly, should report any abdominal symptoms (especially GIGIbleeding) particularly ininthe initial stages ofoftreatment. When GIGI bleeding or concomitant low dose aspirin, oror other any unusual unusual abdominal symptoms (especially bleeding) particularly the initial treatment. When bleeding been reported with all NSAIDs at anyparticularly time during treatment, with or without any warning symptoms a previous history of serious symptoms GI events. Theshould risk of report GI bleeding, ulceration or perforation is higher with NSAID doses, inof patients withstages a history of ulcer,GI particularly if complicated with a history of GI toxicity, when elderly, should report anyorunusual abdominal (especially GI bleeding) particularly inincreasing the initial stages treatment. When bleeding or or ulceration occurs patients receivingNurofen NurofenExpress ExpressTablets, Tablets,the thetreatment treatmentshould shouldbe bewithdrawn. withdrawn.Caution Cautionshould shouldbe be advised advised in patients patients receiving receiving concomitant medications which could increase the ofofulceration ororbleeding, such corticosteroids, anticoagulants such asas ulceration occurs in in patients receiving which could increase therisk risk ulceration bleeding, suchasasoral oral corticosteroids, anticoagulants such with haemorrhage or perforation, in the elderly. These patients should commence treatment on the lowest dose available. Combination therapyconcomitant with (e.g. misoprostol or proton pump inhibitors) be considered for these patients, and alsosuch for patients requiring hdrawn. Caution should beand advised in patients receiving concomitant medications whichin could increase theprotective risk medications of agents ulceration or bleeding, such as oralshould corticosteroids, anticoagulants as warfarin, selective serotonin reuptakeinhibitors inhibitorsororanti-platelet anti-plateletagents agentssuch suchasasaspirin. aspirin.Caution Caution(discussion (discussionwith withdoctor doctor or or pharmacist) pharmacist) is is required prior to treatment in patients with of ororuncontrolled hypertension, congestive heart failure, cardiac oedema, established selective reuptake prior toreport treatment in patients withaahistory history ofcontrolled controlled uncontrolled hypertension, congestive heart cardiac oedema, established concomitant lowserotonin dose aspirin, or other drugs likely to increase gastrointestinal risk.to Patients with a history of GI toxicity, particularly whenrequired elderly, should any abdominal symptoms (especially GI bleeding) particularly the initial stages of failure, treatment. When GI bleeding or ionwarfarin, (discussion with doctor or pharmacist) is required prior treatment in patients with a history of controlled or unusual uncontrolled hypertension, congestive heartinfailure, cardiac oedema, established ischaemic heart disease, peripheral arterialdisease diseaseand/or and/orcerebrovascular cerebrovasculardisease. disease.Similar Similarconsideration considerationshould shouldbe be made before before initiating initiating longer-term longer-term treatment of with risk factors for events hypertension, hyperlipidaemia, diabetes mellitus and smoking). ischaemic heart disease, peripheral arterial treatment medications of patients patients with risk factors forcardiovascular cardiovascular events(e.g. (e.g. hypertension, hyperlipidaemia, diabetes mellitus and smoking). ulceration occurs in patients Nurofen Express Tablets, the treatment should be withdrawn.of Caution shouldmade be advised patients receiving concomitant which could increase the risk of ulceration or bleeding, suchdiabetes as oral corticosteroids, anticoagulants such as consideration should bereceiving made before initiating longer-term treatment patients with riskinfactors for cardiovascular events (e.g. hypertension, hyperlipidaemia, mellitus and smoking). Prolonged use of any type of painkillerforforheadaches headachescan canmake makethem themworse. worse.IfIfthis thissituation situationisisexperienced experiencedor orsuspected, suspected, medical medical advice advice should should be be obtained and treatment should be discontinued. The diagnosis ofof'Medication Overuse Headache should bebe suspected inin patients who have Prolonged use of any type of painkiller obtained and treatment should be discontinued. The diagnosis 'Medication Overuse Headache should suspected patients who have warfarin, selectiveor serotonin reuptake medical inhibitors or advice anti-platelet agents such aspirin. Caution (discussion with doctor or pharmacist) is required prior to treatment in patients a history of controlled or uncontrolled hypertension, congestive heart failure, oedema, established n is experienced suspected, should beas obtained and treatment should be discontinued. The diagnosis ofwith 'Medication Overuse Headache should be suspected incardiac patients who have frequent or daily headaches despite (or because of ) the regular use of headache medications. Clinical trial and epidemiological data suggest that use of ibuprofen, particularly at high doses (2400mg daily) and in long term treatment may be associated with a small increased risk of arterial frequent ortrial daily despite (or because of ) the regular use ofthat headache medications. Clinical particularly trialshould and epidemiological data suggest that use oftreatment ibuprofen, particularly at high dosestreatment (2400mg daily)may and in be long term treatment with may beaassociated with a small increased risk of arterial ischaemic heartheadaches disease, peripheral arterial disease and/or cerebrovascular disease. consideration be made initiating longer-term patients riskterm factors for cardiovascular events (e.g. hypertension, hyperlipidaemia, mellitus and of smoking). ns. Clinical and epidemiological data suggest use ofSimilar ibuprofen, at before high doses (2400mg daily)ofand in with long associated small diabetes increased risk arterial thrombotic events (for example myocardialinfarction infarctionororstroke). stroke).Overall, Overall,epidemiological epidemiologicalstudies studiesdo donot notsuggest suggestthat that low low dose dose ibuprofen ibuprofen (e.g. (e.g. < < 1200mg 1200mg daily) is associated with an increased risk of myocardial infarction. Serious skin reactions, some ofofthem fatal, including Exfoliative thrombotic events (for example myocardial daily) is associated with an increased risk of myocardial infarction. Serious skin reactions, some them fatal, including Exfoliative Prolonged use of any type of painkiller for headaches can make them worse. If this situation is experienced or suspected, medical advice should be obtained and treatment should be discontinued. The diagnosis of 'Medication Overuse Headache should be suspected in patients who have tudies do not suggest that low dose ibuprofen (e.g. < 1200mg daily) is associated with an increased risk of myocardial infarction. Serious skin reactions, some of them fatal, including Exfoliative Dermatitis, Stevens-Johnson syndromeand andToxic ToxicEpidermal EpidermalNecrolysis, Necrolysis,have havebeen beenreported reported veryrarely rarelyin in associationwith with the the use of of NSAIDs. Patients Patients appear to be at risk of these reactions early ininthe ofoftherapy, the ofofthe occurring inin the majority of of cases Dermatitis, Stevens-Johnson appear toin bethe at highest highest risk of reactions early thecourse course therapy, theonset onset thereaction reaction occurring the majority cases frequent daily headachessyndrome despite (or the because of )of theNSAIDs. regular use of headache medications. Clinical trialassociation and epidemiological data NSAIDs. suggest that use of ibuprofen, particularly at high doses (2400mg daily) and in longthe term treatment may be associated a small increased of arterial very rarelyor in association with use Patients appearvery to be at highest risk ofuse these reactions early course ofthese therapy, the onset of reaction occurring inwith the majority ofrisk cases within the first month of treatment. Nurofen Express Tablets should be discontinued at the first appearance of skin rash, mucosal lesions, or any other sign of hypersensitivity. Renal impairment as renal function may deteriorate. Hepatic dysfunction. Patients with bronchospasm or SLE within the firstevents monthof ofskin treatment. Nurofen Express Tablets should be discontinued at the first appearance of skinthat rash, mucosal lesions, or any< other signdaily) of hypersensitivity. Renal impairment function may deteriorate. Hepatic dysfunction. Patients withincluding bronchospasm or SLE thrombotic (for example myocardial infarction or stroke). epidemiological studies do not suggest low doseimpairment ibuprofen (e.g. 1200mg is associatedmay with an increased riskasofrenal myocardial infarction. Serious skin reactions, some of them fatal, Exfoliative first appearance rash, mucosal lesions, orOverall, any other sign of hypersensitivity. Renal as renal function deteriorate. Hepatic dysfunction. Patients with bronchospasm or SLE should consult their doctor before taking this medicine. Bronchospasm may be precipitated in patients suffering from or with a previous history of bronchial asthma or allergic disease. There is some evidence that drugs which inhibit cyclo-oxygenase/prostaglandin synthesis may cause consult their doctor before taking this Toxic medicine. Bronchospasm may precipitated in patients suffering fromwith ordisease. with a previous history bronchial asthma or allergic disease. is some evidence that drugs whichthe inhibit cyclo-oxygenase/prostaglandin may cause Dermatitis, Stevens-Johnson syndrome and Epidermal Necrolysis, have been reported very rarely in association the use of NSAIDs. Patients appear to be at highest of theseThere reactions early in the course of therapy, onset of the reaction occurring in thesynthesis majority of cases d inshould patients suffering from or with a previous history ofbe bronchial asthma or allergic There is of some evidence thatrisk drugs which inhibit cyclo-oxygenase/prostaglandin synthesis may cause impairment of female fertility by an effect on ovulation. This is reversible on withdrawal of treatment. As NSAIDs can interfere with platelet function, they should be used with caution in patients with intracranial haemorrhage and bleeding diathesis. If you are pregnant, elderly or have impairment of female fertility by an effect on ovulation. This isshould reversible on withdrawal of NSAIDs canrash, interfere withlesions, platelet they be used with caution in patients with haemorrhage diathesis. If you are pregnant, elderly have within theAs first month of treatment. Nurofen Express Tablets be discontinued thetreatment. first appearance of skin mucosal orfunction, any other signshould of hypersensitivity. Renal impairment asand renalintracranial function may deteriorate.and Hepatic dysfunction. Patients with bronchospasm ororSLE reatment. NSAIDs can interfere with platelet function, theyatshould beAsused with caution in patients with intracranial haemorrhage bleeding diathesis. Ifbleeding you are pregnant, elderly or have asthma or are receiving regular medical treatment please consult your doctor before taking this medication. Each tablet contains an average of 24.6mg (200mg) or 49.2mg (400mg) of sodium. This should be considered in patients whose overall intake of sodium must be markedly restricted. asthma orconsult are receiving regular medical treatment please consult your doctor taking this medication. Each (400mg) tablet ansodium. average of 24.6mg (200mg) or 49.2mg (400mg) of sodium. should be considered in patients whose overall intake of sodium must be markedly restricted. should theirEach doctor before taking this medicine. Bronchospasm may before be precipitated in patients suffering from orcontains with aof previous historyThis of bronchial asthma or allergic disease. There is This some evidence that drugs which inhibit cyclo-oxygenase/prostaglandin synthesis may cause this medication. tablet contains an average of 24.6mg (200mg) or 49.2mg should be considered in patients whose overall intake of sodium must be markedly restricted. There is a risk of renal impairment in dehydrated adolescents. Interaction with other medicinal products and other forms of interaction: known to interact with the following (please see SPC for full details): Corticosteroids, Anti-coagulants, Anti-platelet agents and SSRIs , Anti-hypertensive impairment of female fertilityforms by in andehydrated effect on ovulation. Thisknown is reversible oninteract withdrawal of treatment. Asand NSAIDs interfere with platelet function, they should beCorticosteroids, used with(please cautionsee in SPC patients with intracranial haemorrhage and bleeding diathesis. you are ,pregnant, or have is a risk of renal impairment adolescents. Interaction with other medicinal products othercan forms of interaction: known interact with the following for full details): Corticosteroids, Anti-coagulants, Anti-platelet agents and SSRIselderly , Anti-hypertensive nalThere products and other of interaction: to with the following (please see SPC fortofull details): Anti-coagulants, Anti-platelet agents andIfSSRIs Anti-hypertensive (ACE inhibitors and Angiotensin II Antagonists) , Diuretics, Cardiac glycosides, Lithium, Methotrexate, Ciclosporin, Other NSAIDs including cyclooxygenase-2 selective inhibitors, Aminoglycosides, Probenecid, Oral hypoglycaemic agents, Zidovudine, Mifepristone, Tacrolimus, Quinolone asthma or areand receiving regular treatment pleaseCardiac consult your doctorLithium, before taking this medication. EachOther tabletNSAIDs contains an average of 24.6mg (200mg) or 49.2mg (400mg) of sodium. ThisProbenecid, should be considered in patientsMifepristone, whose overall intakeTacrolimus, of sodium must be markedly restricted. hotrexate, Ciclosporin, Other NSAIDs including cyclooxygenase-2 selective inhibitors, Aminoglycosides, Probenecid, Oral hypoglycaemic agents, Zidovudine, Quinolone (ACE inhibitors Angiotensin IImedical Antagonists) , Diuretics, glycosides, Methotrexate, Ciclosporin, including cyclooxygenase-2 selective inhibitors, Aminoglycosides, Oral hypoglycaemic agents, Zidovudine, Mifepristone, Tacrolimus, Quinolone antibiotics and low dose aspirin. Fertility, Pregnancy and Lactation: Ibuprofen is not recommended during the first six months of pregnancy and is contraindicated in the last trimester of pregnancy. Ibuprofen and its metabolites can pass in very small concentrations into the breast milk. No There during is aand risklow of renal in dehydrated Interaction medicinal products forms of interaction: known toisinteract with the following seeof SPC for full details): Corticosteroids, Anti-coagulants, andthe SSRIsbreast , Anti-hypertensive mended the first months ofadolescents. pregnancy and with is contraindicated inand the last trimester of pregnancy. Ibuprofen its metabolites can pass initsvery small concentrations into milk. No antibiotics doseimpairment aspirin.six Fertility, Pregnancy and Lactation: Ibuprofen isother not recommended during theother first six months of pregnancy and contraindicated in theand last(please trimester pregnancy. Ibuprofen and metabolites can passAnti-platelet in very smallagents concentrations into the breast milk. No harmful effects to infants are known, so it is not necessary to interrupt breast-feeding for short-term treatment with the recommended dose for mild to moderate pain and fever. Side Effects: Haematopoietic disorders (anaemia, leucopenia, thrombocytopenia, pancytopenia, (ACE inhibitors Angiotensin II Antagonists) , Diuretics,toCardiac glycosides, Lithium, Ciclosporin, Other NSAIDs cyclooxygenase-2 selective Probenecid, Oral hypoglycaemic Zidovudine, Mifepristone,pancytopenia, Tacrolimus, Quinolone ort-term treatment with the recommended dose for mild to moderate and fever. Sideincluding Effects: Haematopoietic disorders (anaemia, leucopenia, thrombocytopenia, pancytopenia, harmful effects toand infants are known, so it is not necessary interrupt breast-feeding forMethotrexate, short-term pain treatment with the recommended dose for mild to moderate paininhibitors, and fever.Aminoglycosides, Side Effects: Haematopoietic disorders (anaemia, agents, leucopenia, thrombocytopenia, agranulocytosis) are very rare - first signs are fever, sore throat, superficial mouth ulcers, flu-like symptoms, severe exhaustion, nose and skin bleeding, and bruising. Hypersensitivity reactions consisting of urticaria and pruritus (uncommon), severe hypersensitivity reactions including antibiotics and are low doserare aspirin. Pregnancy Lactation: Ibuprofen not recommended during the first six monthsnose of pregnancy and is contraindicated inHypersensitivity the last trimester of pregnancy. Ibuprofen and itsand metabolites can pass in very small concentrations into the breast milk. No likeagranulocytosis) symptoms, severe exhaustion, nose and skin bleeding, and bruising. Hypersensitivity reactions consisting of urticaria and reactions pruritus (uncommon), severe reactions reactions including very - firstFertility, signs are fever, soreand throat, superficial mouthis ulcers, flu-like symptoms, severe exhaustion, and skin bleeding, and bruising. consisting of urticaria pruritus hypersensitivity (uncommon), severe hypersensitivity including tongue and laryngeal swelling, dyspnoea, tachycardia, hypotension (anaphylaxis, angioedema or severe shock) are very rare. Aggravated asthma, bronchospasm. Respiratory tract reactivity comprising asthma or dyspnoea. Headache, dizziness. Aseptic meningitis (very rare). Impaired harmful to infants are very known, so ittachycardia, is Aggravated not necessary to interrupt breast-feeding for short-term treatment the recommended dose for mild to moderate pain and Side Effects: comprising Haematopoietic disorders (anaemia, leucopenia, thrombocytopenia, pancytopenia, matongue or severe shock) are rare. asthma, bronchospasm. Respiratory tract reactivity comprising asthma orfever. dyspnoea. Headache, dizziness. Aseptic meningitis (very rare). Impaired andeffects laryngeal swelling, dyspnoea, hypotension (anaphylaxis, angioedema or severe shock) with are very rare. Aggravated asthma, bronchospasm. Respiratory tract reactivity asthma or dyspnoea. Headache, dizziness. Aseptic meningitis (very rare). Impaired hearing (uncommon). Cardiac failure, oedema, hypertension (very rare). Abdominal pain, nausea and dyspepsia (uncommon) Diarrhoea, flatulence, constipation and vomiting (rare). Peptic ulcers, perforation or gastrointestinal haemorrhage, malaena, haematemesis, sometimes fatal, agranulocytosis) are Cardiac very(uncommon) rarefailure, - first signs are Diarrhoea, fever, sore throat, superficial mouth ulcers, severe exhaustion, nose and skin bleeding, and bruising. consisting of urticaria and malaena, pruritus (uncommon), severe hypersensitivity reactions including ausea and dyspepsia flatulence, constipation and vomiting (rare). Peptic ulcers, perforation or gastrointestinal haemorrhage, haematemesis, sometimes fatal, hearing (uncommon). oedema, hypertension (very rare). Abdominal pain,flu-like nauseasymptoms, and dyspepsia (uncommon) Diarrhoea, flatulence, constipation andHypersensitivity vomiting (rare).reactions Peptic ulcers, perforation or gastrointestinal haemorrhage, malaena, haematemesis, sometimes fatal, particularly in the elderly, ulcerative stomatitis, gastritis, exacerbation of colitis and Crohn’s disease (very rare). Liver disorders, especially in long-term treatment (very rare). Severe forms of skin reactions such as bullous reactions including Stevens-Johnson Syndrome, erythema multiforme tongue and laryngeal swelling, dyspnoea, tachycardia, hypotension (anaphylaxis, angioedema or(very severe shock) are very rare.forms Aggravated asthma, bronchospasm. Respiratory tract forms reactivity comprising asthma orbullous dyspnoea. Headache, dizziness. Aseptic meningitis (very erythema rare). Impaired disease (very rare). Liver disorders, especially in long-term treatment rare). Severe ofinskin reactions such as bullous reactions including Stevens-Johnson Syndrome, erythema multiforme particularly in the elderly, ulcerative stomatitis, gastritis, exacerbation of colitis and Crohn’s disease (very rare). Liver disorders, especially long-term treatment (very rare). Severe of skin reactions such as reactions including Stevens-Johnson Syndrome, multiforme and toxic epidermal necrolysis can occur (very rare). Acute renal failure, papillary necrosis, especially in long-term use associated with increased serum urea and oedema (very rare), decreased haemoglobin levels and decreased urea clearance (very rare). Name and Address of Marketing hearing (uncommon). Cardiac failure, oedema, hypertension (very rare). Abdominal pain, especially nausea and dyspepsia (uncommon) flatulence, constipation andlevels vomiting (rare). Peptic ulcers, perforation or gastrointestinal malaena, haematemesis, sometimes fatal, specially long-term use associated with increased serum urea and oedema (very rare), Diarrhoea, decreased haemoglobin and urea clearance (veryhaemorrhage, rare). Name and Address Marketing and toxicin epidermal necrolysis occur (very rare). renal failure, papillary necrosis, long-term associated increased serum urea and oedema (very rare),decreased decreased haemoglobin levels and decreased urea clearance (very rare). Name andof Address of Marketing Authorisation Holder: Reckittcan Benckiser Ireland Ltd,Acute Citywest Business campus, Dublin 24, Ireland. PAinNumber: PA use 979/32/10 and with PA 979/32/11 particularly in the elderly, stomatitis, exacerbation of colitisDublin and Crohn’s disease rare).PA Liver disorders, especially in long-term treatment (very rare). Severe forms of skin reactions such as bullous reactions including Stevens-Johnson Syndrome, erythema multiforme eland. PA Number: PA ulcerative 979/32/10 andgastritis, PA 979/32/11 Authorisation Holder: Reckitt Benckiser Business campus, 24, Ireland. PA(very Number: 979/32/10 PA 979/32/11 For full prescribing information, pleaseIreland consultLtd, theCitywest SPC which is available on www.medicines.ie. For product queries, please and call (01) 630 5429 or contact the MAH above. epidermal necrolysisplease can occur (very rare). renal failure, necrosis, in long-term useplease associated with630 increased urea oedema es.ie. For product queries, please call (01) 630 5429 orpapillary contact theespecially MAH above. Forand fulltoxic prescribing information, consult the SPCAcute which available on www.medicines.ie. For product queries, call (01) 5429 orserum contact theand MAH above.(very rare), decreased haemoglobin levels and decreased urea clearance (very rare). Name and Address of Marketing Legal Category: Retail Sales through Pharmacy only. Date of is preparation: May 2016. Authorisation Holder: Reckitt Benckiser Irelandonly. Ltd, Citywest Business campus, Dublin 24, Ireland. PA Number: PA 979/32/10 and PA 979/32/11 Legal Category: Retail Sales through Pharmacy Date of preparation: May 2016. For full prescribing information, please consult the SPC which is available on www.medicines.ie. For product queries, please call (01) 630 5429 or contact the MAH above. 1.Steiner TJ, et al. J Headache Pain. 2007;8: S3-47 LegalTJ,Category: Retail Sales through 1.Steiner et al. J Headache Pain. 2007;8: S3-47 Pharmacy only. Date of preparation: May 2016. 2.Cathcart S, et al. Cephalagia. 2010; 30(10): 1250-1267 2.Cathcart S, et al. Cephalagia. 2010; 30(10): 1250-1267 3.RB market research, survey, Pain. 2013,2007;8: Headache Awareness Week, 1-33, 1010 participants. 1.Steiner TJ, et al. J Headache S3-47 3.RB market research, survey, 2013, Headache Awareness Week, 1-33, 1010 participants. 4.Moore A,S,etetal.al.Pain. 2014. 155(1):14–21 2.Cathcart Cephalagia. 2010; 30(10): 1250-1267 4.Moore A, et al. Pain. 2014. 155(1):14–21 5.Nurofen Express 400mg Maximum Strength Tablet SPC. Accessed 22/02/2017 http://www.medicines.ie/medicine/15024/SPC/Nurofen+Express+Maximum+Strength+400mg+Tablets/ 3.RB market research, survey, 2013, Headache Awareness Week, 1-33, 1010 participants. SPC/Nurofen+Express+Maximum+Strength+400mg+Tablets/ 5.Nurofen Express 400mg Maximum Strength Tablet SPC. Accessed 22/02/2017 http://www.medicines.ie/medicine/15024/SPC/Nurofen+Express+Maximum+Strength+400mg+Tablets/ 4.Moore A, et al. Pain. 2014. 155(1):14–21 ALWAYS READ THE LABEL. Date of preparation: Mar 2017 IRL/N/0317/0017 5.Nurofen Express 400mg Maximum Strength Tablet SPC. Accessed 22/02/2017 http://www.medicines.ie/medicine/15024/SPC/Nurofen+Express+Maximum+Strength+400mg+Tablets/ ALWAYS READ THE LABEL. Date of preparation: Mar 2017 IRL/N/0317/0017

ALWAYS READ THE LABEL. Date of preparation: Mar 2017 IRL/N/0317/0017


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A holistic approach to health As Irish consumers have more in their pockets, they are increasingly becoming concerned with their health, and consuming goods that are natural, organic or holistic. One company that has benefited from this growing concern amongst Irish consumers is Cellnutrition. Cellnutrition have an ethos dedication to caring for and nourishing their consumers in the UK and Ireland, and are committed to supplying the consumer and our customers with the “finest gifts from nature, high quality mineral supplements and by-products,” noting that it wishes to “share our knowledge and educate people so that they can make better decisions about their cellular health and bodies.” Here, Irish Pharmacy News speaks with Nicola Abbott, CEO of Cellnutrition, about a holistic approach to health, the Irish market, and Rene Quinton – the work of whom informs and inspires her company’s approach. An expanding business A growing and expanding start-up, recently, Cellnutrition have just moved their headquarters west, from Dublin to Galway. “In January I was promoted from Head of Operations to CEO, so we said we’d make the decision then to make the move” Dubliner Nicola says, speaking to Irish Pharmacy News. “The premises are in Oranmore, and we’re there for the next year, so it’s not too far from home!” As Nicola becomes accustomed to life in Galway, Cellnutrition continue to expand and grow as their Quinton Hypertonic and Isotonic products grow in popularity. Quinton is gaining recognition as an important nutritional supplement to maintain cellular health, supporting the body in its fight to resist illness and disease for a healthy life. Retail beginnings Nicola’s professional background in retail, she says, prepared her for the role she now plays in the company. “My background would have been retail management – I would have been in high street retail for about 15 or 20 years, so I had plenty of experience in that regard,” she continues. “Every other job I had probably set me up for this without even realising it; I started my career in

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the airport, would you believe! It really does help with understanding a retail environment today. At that time, I also had a keen interest in all things holistic and alternative as well, so that would have been a passion and hobby of mine in my spare time, before I came onboard with Cellnutrition.” “Because of my background, the position I initially had discussed with John was Office Manager, but after sitting down with John (Kelleher, Founder of Cellnutrition), it was clear that I’d be much better suited to operations where I could utilise my skills completely. So, that’s where I ended up in the company,” she says. “And I also went back to college part-time a few years back and did a business degree in HR management. I suppose it just tied in with my ethos of educating and helping people whilst still having the business aspect to it, which to me meant helping people on a larger scale!” A typical day of work, at Cellnutrition she says, can vary greatly. “I suppose because we’re a startup, and just a year in the Irish Market, each day is different which is one of the things I love about this job. Because we not only deal with the Irish Market, I could be in Sunderland with the UK team, in Dublin or Galway on any given day. It really does vary from day to day. Whist some of my job role is office based I’m out and about a lot. It’s about getting our products and message out there!” Drawbacks of modern living “I suppose one of the things that appealed to me was John Kelleher’s passion for helping people, which is what would have me take an interest in the first place. I’m also very interested in things like Reiki and general wellbeing – again, because life is so stressful, and it’s important that people get some down time. The whole ethos at Cellnutrition is to teach and educate people about minerals and their body, and about what they’re missing in their diets and how we can help to bring them back into balance.” “Because the reality is that we

Nicola Abbott, CEO, Cellnutrition

The reality is, this is the world we’re living in: 100 years ago, we didn’t have the food that we have now, and it wasn’t nearly as manufactured simply do not have the same amount of minerals that we used to have, and there are so many diseases and illnesses that can be traced back to a lack of minerals!” she says. “Lack of magnesium, for example, can lead to a lack of sleep, to anxiety, and so on. And the thing about the ampoules that we have, is that you are getting 78 minerals, and trace elements in the correct proportion that your body needs it. The Isotonic matches that of

our human blood plasma and extracellular fluid.” Cellnutrition’s website is full of testimonials of people who swear by their products, due to their positive effects on their wellbeing and health. One such testimony reads: “I have suffered from MS since 2008, but wasn’t properly diagnosed until 2014 after another relapse. I suffered heavily from fatigue, numbness, weakness in the left leg


10mg Film-Coated Tablets (Cetirizine Dihydrochloride).

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* Adults, elderly and children aged 12 years and over. Medicinal product not subject to medical prescription. Further information is available from the Marketing Authorisation Holder: Rowex Ltd., Bantry, Co. Cork. Ireland. Freephone: 1890 304 400. Fax: 027-50417. PA: 711/75/2, Date of preparation (02-17) CCF No: 19421. Always read the leaflet. Consult your doctor or pharmacist if symptoms persist. Ref 1: IMS Data.

Rowa Pharmaceuticals Ltd., manufacturing in Bantry, Co. Cork.


Available in pharmacy

But emergency contraception has.

ellaOne® is the most effective emergency contraceptive pill1

www.ellaonepharmacists.ie

exécution

Further information available from: HRA Pharma, Haines House, 21 John Street, Bloomsbury, WC1N 2BF, London. Freephone: 1800 812 984. Email: med.info.ie@hra-pharma.com

30, rue Saint-August 75002 PARIS (France tél. : +33 (0)1 42 66 4 fax : +33 (0)1 42 66 www.byagencydesign

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DATE :

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Adverse events should be reported. Reporting forms and information can be found at www.hpra.ie. Adverse events should also be reported to HRA UK & Ireland Ltd on Freephone: 1800 812 984 or email: med.info.ie@hra-pharma.com

*unprotected sexual intercourse

1. Glasier AF et al. Lancet 2010; 375: 555-62.

Date of preparation: March 2016

PLAN / CUTTING LINES : IMPRESSION / PRINTING PROCESS : OFFSET SUPPORT / PRINTING MEDIUM : WHITE CARDBOARD POLICES / FONTS : GILL SANS

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Profile and forgetfulness. I was introduced to Quinton Isotonic in January 2017, which I was told would help my body right down to my cells, and since then I have felt better in the last few months than I have in the last 9 year.

Biscay. The seawater is then transported under strict conditions to pharmaceutical grade laboratories in Alicante, Spain, where it undergoes cold microfiltration to ensure its purity and preserve its organic qualities.

“I no longer feel fatigued, the feeling has returned in my leg and I can feel myself getting stronger every day as I can now manage to do an exercise class once a week which I previously couldn’t. I wish I’d discovered Quinton earlier as it has changed my life”

Afterwards, it is then sealed in special glass ampoules to become Quinton Hypertonic. Quinton Isotonic is created by mixing the seawater with a specific spring water to reduce the concentration of minerals so that it matches that of human blood plasma and extracellular fluid.

Nicola continues, explaining that she hears stories like those on the Cellnutrition website on a very frequent basis. “We’ve had some fantastic results, a woman got in touch with us a few weeks back: her son has autism and has been non-verbal for a long time, and wasn’t sleeping. After taking the product for two-and-a-half weeks he’s now sleeping through the night. And he has tried three new foods, which according to his Mam is unheard of. And we get stories like that all the time, about people benefiting from receiving the minerals that they need.” “The beauty of the product, as well, is that it’s 100% natural, so everyone can take it and there are no side-effects. So, that itself is extremely beneficial.” Carrying on the legacy of Rene Quinton The company’s holistic approach is inspired and informed by the work of Rene Quinton, who was a French psychologist and biologist born in the late 1800’s. In the decades following his death, Rene Quinton’s holistic approach to health and prevention of disease gradually declined as pharmaceutical medicines, based more on Pasteur’s Germ Theory, gained popularity within the Medical Schools and Doctors surgeries. In 1982, changes in EU pharmaceutical regulations led to Quinton being phased out as an injectable medicine. It re-emerged as a nutritional supplement in drinkable form. In 1996, Laboratoires Quinton, based in Alicante, Spain, acquired the legal patents and rights to produce Cellnutrition Quinton products. Today, the company says, increasing antibiotic resistance to modern drugs and the undesirable side effects that they have on people have heralded a welcome renaissance in preventative medicine. Laboratoires Quinton International SL follows René Quinton’s traditions of harvesting Quinton seawater from a pristine oceanic plankton bloom in the Bay of

Promoting Innovation “The reality is, this is the world we’re living in: 100 years ago, we didn’t have the food that we have now, and it wasn’t nearly as manufactured,” Nicola continues, explaining the importance of products like Quinton. “Whilst we have distributions rights with Quinton for Korea, Germany the UK and Ireland, we also now have World distribution rights for Totum Sport and it’s going to be huge. We’re looking to build on our already very successful portfolio of products. It’s all about getting the cell right – because if you don’t have healthy cells, nothing else is going to work for you. So, anything that we bring in, we need to keep that in mind. Any new products we bring in will have to be very innovative, and very different. “I do feel that Irish consumers in particular will go out of their way to find a healthier alternative, and that’s where the pharmacist or other healthcare professionals can come in, because people will seek their advice before going to their doctor. We would recommend Quinton Isotonic to anyone with an underlying condition or ongoing ailment as it gently replenishes the body’s cells, while Quinton Hypertonic is for people who are generally healthy, want to improve their overall health and wellbeing and give their body a bit of a boost!” “It’s a very innovative product, there’s really is nothing like it. You won’t get somebody buying it, who does not become a repeat customer. And you can ask pharmacists that stock it and they will tell you that themselves!”. MULLINS PHARMACY REFLECT ON SUCCESS As Cellnutrition approach their first birthday in the Irish pharmacy market, we wanted to hear the stories of the real pharmacies that stock the products and get their opinions on the ‘who, why and how’ about the mineral revolution. Mullins Pharmacy Salthill is an independent, family owned, Irish company; founded in 2004. Owned

and managed by a brother and sister pharmacist-team, Adrian and Sinead Mullins (MPSI), they are located in the heart of Salthill Village. They pride themselves on great customer service and a fantastic product range which they truly believe sets them apart. As well as operating late-night pharmacy hours, they also offer personalised advice on skincare, smoking cessation, BMI and dietary advice, teeth whitening, medication use reviews and EasyMed Blisterpack dispensing. They have stocked Cellnutrition products since February 2017 after Sinead first heard about them from her sister and various online bloggers who had raved about the results. Read on to find out more about the successes they have had with Cellnutrition Quinton. What results have your customers experienced since using Quinton? The results experienced by our customers range from raised levels of energy and more radiant skin to general boosts in energy and well-being. Others have reported an improvement in their quality of sleep and an overcoming of fatigue in people with long-term or chronic illness. What benefits have they noticed? The benefits lie in the speed with which they notice the improvement. Because fatigue is a common complaint amongst our community they have seen an increase in energy that leads to the ability to exercise more and a general boost in immunity. This in turn has meant less sickness for those who continue to take Quinton. Benefits are both physical and emotional i.e. Skin, well-being, mood, sleep etc.

Mullins Pharmacy is located in the heart of Salthill village which is an area known for its healthy lifestyle and active, retired community. The promenade and sports facilities (triathlon clubs, walking clubs, yoga centres, dance halls, golf course) offer wonderful amenities to the local residents and this is reflected in their desire to maintain a level of fitness and health via nutritional supplementation and alternative options to standard prescribed medication. We make sure to keep a range of quality supplements in stock from highgrade pure fish oil to Quinton Isotonic and Hypertonic. What is your favourite element with regards to selling Quinton? Our favourite element of Quinton is the speed with which the products work and the fact that there are two options to suit every member of our customer community. The depletion in soil quality combined with a lack of options for those wishing to pursue a purely organic diet mean that we have an option that has been previously unavailable. The fact that the supplement also allows your body to get more benefit from foodstuffs like fruit and vegetable means that there is an added benefit to taking it long-term. Ease of access combined with balanced information on the product's boxes themselves means that every client is well-informed and confident in taking what we consider to be a unique and supportive supplement.

Why do you think MPSI have been so successful selling Quinton? I believe we have been successful in selling Cellnutrition Quinton because we as a staff group have tremendous faith in the product. We make a sustained point of offering alternative remedies to our customers and always advocate the use of 'bio-available' supplements and high-grade probiotics. We have had huge success in promoting Quinton because of the quality of the supplement itself. Various staff members used and reviewed the product with one Mullins Pharmacy Salthill Facebook review being read over 2000 times. This in turn has led to a confident selling group within the shop who can recommend it from personal experience to a broad audience. How important is the supplement market to MPSI and its customers? The supplement market is extremely important to our business and our customers.

Jenny Turnbull, Sinead Mullins and Emma Kunniffe

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News The Mall counter manager receives prestigious qualification An employee of CH Chemists has become just the second person in the country to receive a prestigious qualification in her field. Betesaida Hailegeorgis, the fragrance counter manager at the famous Tralee business in The Mall, has been certified with the Fragrance Foundation UK as a Fragrance Specialist. She passed with Honours to become the second person in the Republic of Ireland to have been certified and awarded the honour. She is currently the only person in Munster to have this qualification. “On behalf of everyone at CH The Mall Tralee we would like to offer our heartfelt congratulations

to Betesaida our Fragrance Counter Manager on becoming a certified fragrance specialist with HONOURS from the Fragrance Foundation UK. Betesaida is the only certified fragrance specialist in Munster & the second person ever to qualify with HONOURS in the republic of Ireland. We wish her the very best!” a statement from The Mall said. Pictured: Betesaida Hailegeorgis, fragrance counter manager with Tina, HR Executive

The High Tech Scheme was initiated in the 1996 Pharmacy Contract to ensure public availability of new expensive , consultant prescribed innovative medicines. Pharmacists could not be expected to purchase or hold stocks, of such a vast array of strengths,especially with short expiries and frequent dose changes. So the costs were borne by the state who reimburse the wholesalers and more latterly many individual drug companies directly. The scheme was set up as a solution and in reaction to the tragic death of a patient in rural Ireland over a Bank Holiday weekend. The patients discharge was not planned and passed away in the supply delay. From an initial cost of £25 m Punt approximately in 1996, the cost has grown exponentially and is reckoned to top 650 m Euro by 2017. So a review is well over due from the tax payers point of view, and the PCRS are to be commended for acting in the interests of probity and the public purse. The intention in the PCRS plan is to have a robust flexible central software tool to control, script authorisation and smooth supply to the patient. Significant state savings, reducing wastage, will accrue, but ensuring patients come first rather than the Byzantine processes requires a changed mind set. Patients will present, in an unplanned discharge over a holiday weekend when PCRS staff will not be present outside of M-F, 9-5. Vast wastage has already occurred. The IPU went to the PCRS,

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10 years ago with a plan to rationalise fridge stock control, to redirect expiring stock to other pharmacies, at a local level and so save perhaps 25M euro annually. The arguments and plan were dismissed over “cold chain integrity”, that pharmacists would under mine patient safety on transfer from car their boots. But at the same time unqualified, untrained, unnamed van drivers are a preferred and safer model for cold chain integrity. These must be the same outsourced individuals who don’t have a fridge box in their hired Transit vans, and have delivered warm boxes to me in the past. There’s a comedy script in there somewhere, but big Pharma is laughing at the state tax payer to the tune of an accumulated quarter of a Billion Euro. That might have built a Children’s Hospital back in the day.... The current practice of Hi Tech drug supply via drug companies directly to Pharmacy, cutting out Wholesalers, should never have been permitted by the PCRS. It was presented as a “customer service “ but was naked greed, bad for patients {delayed supply, closed at weekends, that member of staff is on holiday/sick /on lunch}, confusing for pharmacists and bad for the tax payer as end of month phone calls aggressively try to dump and front load unwanted stock. This shameful nonsense must stop forthwith. The other giant pink elephant that Minister Harris is too youthful to have spotted in his Hawkins House eyrie, is the huge savings

of biosimilars, the generics of high technology. If these were assertively referenced priced, upwards of 100 M Euro annually could be saved on the 3 most frequently used molecules, which account for 200M Euro alone of spend. Clearly big Pharma muscle has bamboozled the PCRS negotiators or been used as a negotiation chip around jobs and taxes remaining in Ireland. The state needs a better procurement negotiating team, in the tax payers interest. I am certain Ryanair could teach a few tricks around squeezing value from the unwilling. They never overpay, it feels like the state always overpays.... Which leads me on to the latest Orkambi supply by Vertex for a small cohort of Cystic Fibrosis sufferers. This is a life changing drug for those with 2 copies of the F508 del mutation in their CFTR gene and is to be welcomed. This is the first time an orchestrated multi-channel social media campaign has forced a policy change. The cost benefit ratio is stark for the tax payer, miraculous for the few hundred individuals concerned. 650M Euro over 10 years is a chunky number when there’s a queue of other worthy and worthier causes lining up to play the now proven media pressure game. This is no way to run public health policy. We need to follow NICE National institute of clinical excellence in UK in value for money, cost/benefit decisions. We have the pharmacoeconomist Prof Barry but his vision and over view display systemic preferences.

I agree with Minister Harris seeking long-term, multi government targets and policies, but short termism and knee jerk reactions always seem to win out. The longer view should be generated internally in Hawkins House but without a dynamic chief Pharmacist there will be no policy vision. The narrow minded cost containment agenda, actually costs more in the long run because consequences are never factored into their budget or domain. Accountants PWC in London did some interesting work on behalf of the PSNC on behalf of English Pharmacists. The unpaid work of pharmacists for which they are not reimbursed or acknowledged, has huge benefits to the patient, NHS and society at large. In a counter factual argument the costs if the pharmacists were to close as the Tories plan would amount to greater than £2.5 billion annually, which is actually more than the state pays them collectively for dispensing per year. Ipso facto. Amazon or remote mail order is actually more costly in the long run to society. That’s the piece of joined up thinking that’s needed for the good of all.


Asthma

Relvar Ellipta is an ICS/LABA for patients (≥12 years) uncontrolled on ICS alone and ‘as needed’ SABA1

24 HOUR EFFICACY

Remind her of what she’s been missing Your choice of treatment could mean your patients don’t have to miss out.

Practical efficacy Relvar® Ellipta® (fluticasone furoate/vilanterol [as trifenatate]) Prescribing information (Please consult the full Summary of Product Characteristics (SmPC) before prescribing) Relvar® Ellipta® (fluticasone furoate/vilanterol [as trifenatate]) inhalation powder. Each single inhalation of fluticasone furoate (FF) 100 micrograms (mcg) and vilanterol (VI) 25mcg provides a delivered dose of 92mcg FF and 22mcg VI. Each single inhalation of FF 200mcg and VI 25mcg provides a delivered dose of 184mcg of FF and 22mcg of VI. Indications: Asthma: Regular treatment of asthma in patients ≥12 years and older not adequately controlled on inhaled corticosteroids and ‘’as needed” shortacting inhaled 2-agonists, where a long-acting 2-agonist and inhaled corticosteroid combination is appropriate. COPD (Relvar 92/22mcg only): Symptomatic treatment of adults with COPD with a FEV1<70% predicted normal (post-bronchodilator) and an exacerbation history despite regular bronchodilator therapy). Dosage and administration: Inhalation only. Asthma: Adults and adolescents ≥12 years: one inhalation once daily of: Relvar 92/22mcg for patients who require a low to mid dose of inhaled corticosteroid in combination with a long-acting beta2-agonist. If patients are inadequately controlled then the dose can be increased to one inhalation once daily Relvar 184/22mcg. Relvar 184/22mcg can also be Relvar® Ellipta® was developed considered for patients who require a higher dose of in collaboration with inhaled corticosteroid in combination with a longacting beta2-agonist. Regularly review patients and reduce dose to lowest that maintains effective symptom control. COPD: one inhalation once daily of Relvar 92/22mcg. Contraindications: Hypersensitivity to the active substances or to any of the excipients (lactose monohydrate & magnesium stearate). Precautions: Pulmonary tuberculosis, severe cardiovascular disorders, heart rhythm abnormalities, thyrotoxicosis, uncorrected

hypokalaemia or patients predisposed to low levels of serum potassium. chronic or untreated infections, diabetes mellitus. Paradoxical bronchospasm – substitute alternative therapy if necessary. In patients with hepatic with moderate to severe impairment 92/22mcg dose should be used. Acute symptoms: Not for acute symptoms, use short-acting inhaled bronchodilator. Warn patients to seek medical advice if shortacting inhaled bronchodilator use increases. Therapy should not be abruptly stopped without physician supervision due to risk of symptom recurrence. Asthma-related adverse events and exacerbations may occur during treatment. Patients should continue treatment but seek medical advice if asthma symptoms remain uncontrolled or worsen after initiation of Relvar. Systemic effects: Systemic effects of inhaled corticosteroids may occur, particularly at high doses for long periods, but much less likely than with oral corticosteroids. Possible Systemic effects include: Cushing’s syndrome, Cushingoid features, adrenal suppression, decrease in bone mineral density, growth retardation in children and adolescents, cataract, glaucoma. More rarely, a range of psychological or behavioural effects including psychomotor hyperactivity, sleep disorders, anxiety, depression or aggression (particularly in children). Increased incidence of pneumonia, including pneumonia requiring hospitalisation, has been observed in patients with COPD receiving inhaled corticosteroids. Physicians should remain vigilant for the possible development of pneumonia in patients with COPD as the clinical features of such infections overlap with the symptoms of COPD exacerbations. Risk factors for pneumonia include: current smoking, older age, low body mass index and severe COPD. The incidence of pneumonia in patients with asthma was common at the higher dose of Relvar (184/22mcg). Patients with rare hereditary problems of galactose intolerance, the Lapp lactase deficiency or glucose-galactose malabsorption should not take Relvar. Interactions with other medicinal products: Interaction studies have only been performed in adults. Avoid -blockers. Caution is

advised when co-administering with strong CYP 3A4 inhibitors (e.g. ketoconazole, ritonavir). Concomitant administration of other sympathomimetic medicinal products may potentiate the adverse reactions of FF/VI. Relvar should not be used in conjunction with other long-acting 2-adrenergic agonists or medicinal products containing longacting 2-adrenergic agonists. Pregnancy and breast-feeding: Experience limited. Balance risks against benefits. Side effects: Very Common (≥1/10): Headache, nasopharyngitis. Common (≥1/100 to <1/10): Candidiasis of the mouth and throat, pneumonia, bronchitis, upper respiratory tract infection, influenza, oropharyngeal pain, sinusitis, pharyngitis, rhinitis, cough, dysphonia, abdominal pain, arthralgia, back pain, muscle spasms, fractures, pyrexia. Uncommon (≥1/1,000 to <1/100): Extrasystoles. Rare (≥1/10,000 to <1/1,000): Hypersensitivity reactions including anaphylaxis, angioedema, rash, urticaria, palpitations, and tachycardia. Tremor, Anxiety. Marketing authorisation (MA) Holder: Glaxo Group Ltd, 980 Great West Road, Brentford, Middlesex TW8 9GS, UK. MA Nrs: 92/22mcg 1x30 doses [EU/1/13/886/002]; 184/22mcg 1x30 doses [EU/1/13/886/005]. Legal category: POM B. Last date of revision: November 2016. Job Ref: IE/FFT/0046/15 (3). Further information available on request from GlaxoSmithKline, 12 Riverwalk, Citywest Business Campus, Dublin 24. Tel: 01-4955000.

Adverse events should be reported to the Health Products Regulatory Authority (HPRA) using an Adverse Reaction Report Form obtained either from the HPRA or electronically via the website at www.hpra.ie. Adverse reactions can also be reported to the HPRA by calling: (01) 6764971. Adverse events should also be reported to GlaxoSmithKline on 1800 244 255. References: 1. Relvar Ellipta Summary of Product Characteristics. GlaxoSmithKline; 2016. IE/FFT/0015/17(1) Date of preparation: April 2017


IPHA Conference

Low Vaccine uptake due to misinformation – Minister for Health “Clear and accurate information about vaccines and their benefits is vital and this valuable document will be a useful tool in the offensive we must all lead to counter many of the current myths concerning vaccination.” “For some, the perceived, often misconceived, risks of vaccines now outweigh the risks of these forgotten infectious diseases. The scare surrounding the MMR vaccine in the 1990s resulted in a large reduction in uptake rates for this vaccine.” Low uptake of HPV vaccine In January 2000 a large outbreak of measles occurred in Dublin and resulted in more than 100 children being hospitalised, 13 children required intensive care treatment, and there were three measles related deaths. “We are now, as all of us here today know and must address, facing a similar situation with respect to the HPV vaccine,” the Minister noted.

IPHA CEO, Minister for Health, Prof Kingston Mills, Dr Brenda Corcoran caption needs finishing off

These are the words of Minister for Health Simon Harris, as he spoke at the launch of the new report into Vaccination uptake to mark World Immunisation Week at the Royal College of Physicians in Ireland, (RCPI), on behalf of the Irish Pharmaceutical Healthcare Association (IPHA). “…The World Health Organisation estimates that up to 3 million lives are saved each year as a result of vaccination. All vaccines undergo long and careful review by scientists, doctors, and regulatory authorities to make sure they are safe,” the minister continued. “Diseases that used to be common in this country and around the world, like polio, measles, diphtheria, whooping cough, Rubella, mumps and tetanus, can now be prevented by vaccination. The Importance of Vaccinations The publication discusses the importance, benefits, safety and future of vaccines, for all stages of life. The science behind vaccination

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is also developing and growing: there are currently over 250 future vaccines in development around the world. The publication advocates for long-term partnership and collaboration between industry and policy makers to ensure existing and future vaccines are made available in Ireland. “Vaccines are universally accepted as one of the most successful and cost-effective public health interventions available. Up to 3 million lives are saved each year and a further three-quarters of a million more protected from the devastating consequences of vaccine-preventable diseases” the Minister noted. High vaccination rates are necessary to sustain the protection of individuals and wider population, as much in Ireland as around the world. The publication also aims to address some of the myths about vaccines. Knowing the facts provides people with the first step towards protecting themselves, their families and the public.

Preventing Cancer Vaccines are also helping us prevent the development of cancer, the minister said. The Hepatitis B vaccine given as part of the 6 in 1 vaccine in the Primary Childhood Immunisation Programme helps prevent cancer of the liver caused by Hepatitis B infection and the HPV vaccine given to school girls can prevent the development of cervical cancer caused by the Human papilloma virus. In Ireland, currently the Primary Childhood Immunisation Programme vaccinates children against 13 serious infectious diseases, and Ireland’s primary Childhood Immunisation Programme are close to the WHO uptake target of 95%. “In recent years, due to the success of our programme, many vaccine preventable diseases have become so infrequent that we have lost the collective memory of how serious some childhood illnesses can be. We cannot become victims of our own success,” the Minister warned.

“Unfounded, false claims have been made of an association between HPV vaccination and a number of conditions experienced by a group of young women. There is no scientific evidence that the HPV vaccine causes any long-term illness. However, this misinformation has led to a significant drop in uptake rates of the HPV vaccine.” Despite the availability of free and effective vaccines, a small number of people make the personal choice not to vaccinate themselves or their children in the belief that vaccines are unsafe or no longer necessary. “Such a decision may put their own life and that of their child at risk, and it may also put at This was an element of the Winter Initiative campaign this year and, as a result, we did see an increase in uptake rates compared to previous seasons and some units achieved or exceeded the target of 40%,” he said. “However, the national rate fell far short of the target of 40%. As people who care for sick and vulnerable patients, and who I know take their duty of care very seriously, I want to encourage everyone in our health service to make it a priority to receive the flu vaccine every year.” Also speaking at the launch, Professor Kingston Mills of the School of Biochemistry and Immunology at Trinity College


Reminder of Precautions to avoid Photosensitivity Reactions with Fastum Gel (ketoprofen gel) A. Menarini Pharmaceuticals Ireland Ltd. wish to remind healthcare professionals of the necessary precautions to avoid the risk of photosensitivity reactions with Fastum Gel. The European Medicines Agency’s Committee for Medicinal Products for Human Use (CHMP) undertook a safety review of topical ketoprofencontaining medicines in 2010 and recommended that doctors should strictly follow the contraindications when prescribing topical ketoprofen. CHMP also recommended that doctors and pharmacists should inform patients on how to use these medicines appropriately to prevent the occurrence of serious skin photosensitivity reactions. A series of risk minimisation measures for Fastum Gel was agreed with the Health Products Regulatory Authority. The Summary of Product Characteristics and the Patient Information Leaflet were updated accordingly and may be found on www.medicines.ie and www.hpra.ie. Patients should be reminded to wash their hands thoroughly after application of the product and to protect treated areas from sunlight by wearing clothing. They should avoid exposing the treated areas to sunlight, even if cloudy, or UVA from sunbeds or solarium during use and for 2 weeks after discontinuation. In addition they should be advised to avoid using Fastum Gel under occlusive bandages and to discontinue Fastum Gel immediately and contact their doctor should any skin reaction develop, including cutaneous reactions after co-application of octocrylene-containing products. A copy of the patient educational leaflet is available from A. Menarini on 01 284 6744 or 1800 283045 or is available at www.hpra.ie A. Menarini would like to remind healthcare professionals that any suspected adverse reactions associated with the use of Fastum Gel should be reported to the Health Products Regulatory Authority at www.hpra.ie or by calling 01 676 4971. Adverse reactions can also be reported to A. Menarini’s Pharmacovigilance Department on 01 284 6744.


a Panadol Extr ts le b ta l o m ta er. ard parace relieving pow ared to stand p in a m p o c re n o e h m *W ive up to 30% Soluble can g

Product Information: Please consult the summary of product characteristics for full product information. Panadol Extra 500mg/65mg Soluble Effervescent Tablets, paracetamol, caffeine. Indications: Relief of mild to moderate pain such as that associated with rheumatism, neuralgia, headache, musculoskeletal disorders, menstrual pain, toothache, fever, symptoms of colds and flu. Dosage: Adults and children 12 years and over: 2 tablets up to 4 times a day. Max 8 tablets in 24 hours. Do not give to children under 12 years. Minimum dosing interval: 4 hours. Contraindications: Hypersensitivity to paracetamol, caffeine or any of the other ingredients. Precautions: Diagnosed liver or kidney impairment, hereditary sugar intolerance, pregnancy, concurrent use of other paracetamol-containing products, excessive caffeine intake, low sodium diet. Do not exceed the stated dose. Prolonged use except under medical supervision may be harmful. Side effects: All very rare: Hypersensitivity reactions including anaphylaxis and skin rash, thrombocytopenia, angiodema, Stevens-Johnson syndrome, bronchospasm, hepatic dysfunction. Frequency unknown: Nervousness, dizziness. Overdose: Immediate medical advice should be sought in the event of an overdose, even if symptoms of overdose are not present. Combined with dietary intake, higher doses of caffeine can cause: insomnia, restlessness, anxiety, irritability, headaches, GI disturbances and palpitations. Legal Category: Pharmacy Only. MA Number: PA 678/39/10. MA Holder: GlaxoSmithKline Consumer Healthcare (Ireland) Limited, Riverwalk, CityWest Business Campus, Dublin 24. Text prepared: July 2016. Further information available on request. Panadol is a registered trade mark of the GSK group of companies. Contains Paracetamol. Always read the label/leaflet.

CHGBI/CHPAN/0057/16


IPHA Conference Legislation allows pharmacists who have the correct training to administer five medicines for saving a life or reducing severe distress in emergency situations in addition to three vaccines. These include: • Seasonal Influenza vaccine • Pneumococcal Polysaccharide vaccine • Herpes Zoster (Shingles) vaccine • Adrenaline injection • Salbutamol inhaler • Glyceryl trinitrate aerosol (sublingual spray) • Glucagon injection • Naloxone injection Minister for Health & IPHA CEO caption needs finishing off Dublin said, “vaccines are crucial in preventing infectious disease. They have eradicated smallpox and polio is soon to follow. “Unfortunately, there appears to be an increasing amount of misinformation on the safety of certain vaccines. Much of this is being spread through social media and dedicated websites and is often not based on scientific facts. This appears to have gained some traction, as demonstrated in the alarming drop in the uptake

of the human HPV vaccine that protects against cervical cancer. It is incumbent on all of us to assess the benefit versus risks and this should be based on sound scientific evidence.” Dr Brenda Corcoran from the National Immunisation Office, added, “Immunisation is a simple, safe and effective way of protecting against certain diseases. However, the benefits of vaccination are not seen unless there are high vaccine uptake

rates, so it is essential we continue to build and maintain vaccine confidence.” Vaccines and Pharmacy Pharmacists can be instrumental in providing patients with information to make informed choices when it comes to immunizations, in terms of the benefits as well as the risks, and in a unique position to identify those patients who are in target groups for certain vaccinations. Pharmacists also may be able to ease the fears of many patients by providing them with the facts as well as the significant risks associated with not being vaccinated. Currently, Irish pharmacists are allowed to distribute certain vaccines. The PSI and the IPU have called for the government to extend this.

Dr Brenda Corcoran

Speaking to Irish Pharmacy News, Pamela Logan of the Irish Pharmacy Union said, “The Irish Pharmacy Union, since 2011, has been advocating for pharmacy vaccinations. We’ve been doing flu vaccinations since 2011, and last year we introduced pneumococcal and shingles as well. “We’ve seen an increase yearon-year in the number of flu vaccinations in pharmacy. In 2015/2016 there were almost 80,000 flu vaccinations, so this is helping to achieve the Irish and the World Health Organisation’s target of 75% vaccination coverage. “We’ve made a proposal to the Minister for Health to increase the number of vaccinations that a pharmacist can give; we’ve shown that we can give vaccines safely and cost-effectively. And for equity of access for patients we believe that more and more vaccines should be offered through community pharmacy.”

Minister for Health Simon Harris

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The cholesterol lowering effec level of evidence

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Red yeast rice food fung During varie pigm

Research proves that red yeast rice has cholesterol lowering effects

RYR for c Japan Chines Nowada supplement

Surveys have shown that potentially 8 out of 10 Irish people over the age of 45 years have raised cholesterol levels13. For those looking for a more natural approach towards their heart health, the cholesterol lowering effect of red yeast rice is supported by a good level of evidence. Red yeast rice (RYR) is produced by fermenting steamed rice with a food fungus of the Monascus genus, mainly Monascus purpureus. During fermentation the fungus produces red pigments and a variety of different cholesterol-lowering monacolins. The pigments give the characteristic red colour to the rice.

Magnitude of RYR’s cholesterol lowering potential A recent meta-analysis in 2015 examined 20 randomized trials consisting of 6,663 patients and showed an average reduction in low-density lipoprotein (LDL) cholesterol of 1,02 mmol/l when comparing RYR to placebo groups. Daily doses varied from 2, 4mg up to 24 mg monacolin K equivalents, with on average 10, 8mg per day.7

RYR can be used as a tolerable alternative to regular statins, since RYR can be used at a lower dose of statin-analogues.

Next to monacolin K, RYR consists of a multitude of components including other monacolins, phytosterols, fibre, B vitamins and unsaturated fatty acids that also exert cholesterol lowering effects. A dose of RYR containing RYR has been used as flavour about 5–7mg of monacolin K is enhancer and food colouring considered as effective in lowering for centuries in the cuisine of The target population are cholesterol as 20–40 mg of pure East Asian countries (China, patients with mild to moderate lovastatin, owing to the presence of Japan, Korea). It is also a remedy hypercholesterolemia and low toby a good The cholesterol lowering effect of red yeast rice is supported those other components.1-3 belonging to the Traditional Chinese moderate cardiovascular risk (i.e. level of evidence Medicine as an aid for digestion Safety and adverse reactions individuals requiring a reduction of and circulation. Nowadays, in LDL cholesterol by up to 20-25%). Some strains of Monascus produce Western countries it isRed largely The preferableby dose for achieving yeast rice (RYR) is produced fermenting steamed ricethe with a mycotoxin citrinin, which can used as a dietary supplement for an average 16-25% reduction in food fungus of the Monascus genus, mainly Monascus purpureus. pose a health risk since it may lowering cholesterol.1-3 LDL cholesterol is also reflected in During fermentation the fungus produces red pigments and akidney injury as found in induce the health claim established monacolins. by the variety of different cholesterol-lowering The Monacolins’ mechanism animal models.1,2 Citrinin content in European Food Safetyred Authority pigments give the characteristic colour to the rice. food supplements based on RYR is of action (EFSA), referring to a daily intake therefore regulated in Europe and RYR has been flavour enhancer and food colouring levelused of atasleast 10 mg of monacolin About 55% to 90% of the should not exceed 2mg citrinine 2,3 for centuries in the cuisine of East Asian countries (China, K from RYR. monacolins content in RYR per kg of food supplement.10 Japan, Korea). It is also a remedy belonging to the Traditional consists of monacolin K that is Hence, in poorly produced RYR Cardiovascular risk reduction Chinese Medicine as an aid for digestion and circulation. identical to lovastatin.1,4 Lovastatin products citrinin can still be found. Nowadays, in Western countries it is largely used as a dietary The ultimate goal for lowering LDL is available in the US and belongs for lowering supplement cholesterol.1-3 Another safety issue is related to cholesterol is the prevention of to the statins, a class of cholesterol the statin-analogue (monacolin K) cardiovascular diseases such as lowering drugs. present in RYR preparations, since atherosclerosis, ischemic stroke Statins and monacolins act lovastatin has been associated and ischemic heart failure. Ideally to lower cholesterol levels by with muscle and liver injury in the LDL cholesterol level should inhibiting HMG-CoA reductase, some individuals.11 be less than 3 mmol/l for which is the rate-limiting enzyme people with low to moderate In the 2015 meta-analysis, the Monacolins’ mechanism of action of the metabolic pathway that cardiovascular risk.8 incidence of renal (evaluated in produces both and About 55% to 90%cholesterol of the monacolins content in RYR consists of monacolin that is identical 2,895 subjects), hepatic (evaluated examining the impactK of Q10. Hence,isstatins andin theResearch Lovastatin available US and belongs to the statins, a class of tocoenzyme lovastatin.1,4 in 2895 patients) and muscle RYR on cardiovascular prognosis monacolins are efficient in lowering cholesterol lowering drugs. (evaluated thoroughly in 105 has been performed in China in a cholesterol, but also reduce the patients) adverse events was largelevels randomized controlled trial reductase, Statins and monacolins act to lower cholesterol by inhibiting HMG-CoA body’s coenzyme Q10 level. This comparable between RYR and consisting of 4,870 patients with a which is the rate-limiting enzyme is why co-supplementation of of the metabolic pathway that produces both cholesterol 3,7 placebo history of and and coenzyme Q10. Hence, statins and monacolins aremyocardial efficient in infarction lowering cholesterol, but (0-5%). RYR preparations with coenzyme moderate hypercholesterolemia. also reduce the body’s coenzyme Q10 level. This is why co-supplementation of RYR Q10 makes sense, even though However, case-by-case Study participants RYR preparations with coenzyme Q10 makes sense, even though its received clinical relevance for statinits clinical relevance for statinassessments in France and Italy 5,6 preparations equivalent to 5-6, induced muscle pain is currently controversial. highlight muscle and liver injury induced muscle pain is currently 4mg of monacolin K per day or as potential safety issues. Within controversial.5,6 placebo for a mean of 4,5 years. the Italian Surveillance System The RYR intervention reduced LDL 3-hydroxy-3-methyl-glutaryl-coenzyme A of Natural Health Products (HMG-CoA) cholesterol levels by 20%, and (assessments from 2002 to 2015) also produced relative decreases causality of muscle and liver in nonfatal myocardial infarction of injuries resulted in 1 certain and Red Yeast Rice 62%, coronary disease mortality HMG-CoA reductase 31 probable cases with RYR (RYR) of 32%, coronary revascularization preparations equivalent to 4-10mg of 33% and total mortality of 33% of monacolin K.1 Similar analyses compared to placebo.2,3,9 carried out by the ANSES French Agency (assessments from 2009 RYR might be suitable for statinMevalonate intolerant patients – why? to 2013) resulted in causality of muscle and liver damage in 2 Risk factors for statin intolerance very likely and 10 likely cases include older age, female sex, (monacolin K dose unknown).11 kidney disease, history of muscle cholesterol coenzyme Q10 7 symptoms and high statin dose. Monacolin K is eliminated from The latter risk factor explains why the body by the CYP3A4 enzyme.

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Drugs and food constituents (i.e. grapefruit, Seville orange and lime) with CYP3A4 inhibitory activity will increase monacolinmechanism K levels in the Monacolins’ of action body and thus contribute to an About 55% to 90% of the monacolins increased risk of adverse events.12

to lovastatin.1,4 Lovastatin is available cholesterol lowering drugs.

Conclusion

Red yeast rice (RYR) is suitable Statins and monacolins actinto lower ch clinical practice to achieve a 16which is the rate-limiting enzyme of th 25% reduction in LDL cholesterol and coenzyme Q10. Hence, in patients with mild to moderate statins and also reduce the body’s coenzyme Q10 hypercholesterolemia when used at coenzyme 10mgpreparations monacolin K with equivalents per Q10 mak induced muscle pain is currently cont day. Close monitoring of symptoms or signs related to malfunctions of kidney, liver and muscle is recommended, even if only a 3-hydroxy-3-methyl-glutaryl-coenzyme A limited number of case reports (HMG-CoA) have been described. RYR users should be advised to avoid eating grapefruit,Red Seville Yeastorange Rice and lime. (RYR)

HMG-CoA reductase

Sofie Noppe, MSc (Biomed Sc)

MorEPA Cholesterol contains 200mg of RYR extract which provides 10mg Monacolin K in each capsule. MorEPA Cholesterol maintains normal Mevalonate cholesterol levels as well as supporting heart function.

References

cholesterol coenzyme Q10 1. Mazzanti G, Moro PA, Raschi E et al. Br J Clin Pharmacol 2017 Jan 17. 2. Nguyen T, Karl M, Santini A. Foods 2017; 6(19). 3. Pirro M, Vetrani C, Bianchi C et al. Nutr Metab Cardiovasc Dis 2017; 27(1):2-17. 4. Mark DA. Am J Cardiol 2010; 106(3):448. 5. Banach M, Serban C, Sahebkar A et al. Mayo Clin Proc 2015; 90(1):2434. 6. Banach M, Mikhailidis DP. Mayo Clin Proc 2015; 90(3):420-1. 7. Gerards MC, Terlou RJ, Yu H et al. Atherosclerosis 2015; 240(2):415-23. 8. ESC/EAS Guidelines for the management of dyslipidaemias. Eur Heart J 2011; 32(14):1769-818. 9. Lu Z, Kou W, Du B et al. Am J Cardiol 2008; 101(12):1689-93. 10. Commission Regulation (EU) No 212/2014 of 6 March 2014. 11. ANSES Request No 2012-SA-0228; 14 February 2014 12. Steffen C. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2017; 60(3):292296. 13. Survey of Lifestyle, Attitudes & Nutrition in Ireland, 2007


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News news brief ¤72M INVESTMENT IN RESEARCH Science Foundation Ireland has announced that it will invest ¤72 million over the next six years in four new world-class SFI Research Centres in Ireland. The new SFI Research Centres will be supported by 80 industry partners who will provide an additional ¤38 million to support cutting-edge basic and applied research with strong industry engagement, economic and societal impact. The decision follows a comprehensive international peer review process involving leading industry and academic experts over the last 12 months. Innovation 2020, the Government's five-year strategy for research and development, science and technology, directs that the network of SFI Research Centres should be further developed to build critical mass in strategic areas of research strength and address enterprise needs. These 12 world-leading SFI Research Centres are recognised internationally for research excellence; attract talent and capital to Ireland; anchor, attract and spin-out businesses; consolidate excellent basic and applied research across Higher Education Institutions; and secure EU and other international funding. The SFI Research Centres announced will address: • Smart manufacturing IT and industrial automation systems, led by Prof Conor McCarthy, University of Limerick (Project Title Confirm); • Biological resources as alternative materials to finite fossil resources, led by Prof Kevin O'Connor, UCD (Project Title - BEACON); • Innovative techniques and processes in Additive Manufacturing, led by Prof Denis Dowling, UCD (Project Title - Deantus); • Diagnosis, monitoring and treatment of chronic and rare neurological diseases - led by Prof David Henshall, RCSI (Project Title - FutureNeuro).

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Minister on Making Medicines more Affordable Minister for Health Simon Harris, at the 3rd Roundtable meeting of EU Health Ministers and CEOs and Heads of Europe-based pharmaceutical companies, signed the Valletta Declaration along with Spain, Italy, Greece, Portugal, Cyprus, Malta and Romania. The Declaration is in line with the Minister’s stated objective since coming into office to work with other countries to make medicines available to patients at affordable prices. The signatories have agreed to work together to explore possible ways to guarantee access to new medicines for patients. A Technical Committee will be established, with the first meeting to take place in June. This group will explore possible areas for cooperation including information sharing, horizon scanning and possible price negotiations and joint procurement. Speaking from Malta this evening, Minister Harris said, “Since coming into office I have seen the challenges our health service and, more importantly, patients have experienced in terms of access to new medicines at an affordable price. International collaboration is key to addressing this issue. The Valletta declaration marks a concrete step forward in this regard. Ireland will continue to build on this and our relationship with other member states in our efforts to secure affordable access for Irish patients to innovative medicines.” The Minister also used the opportunity in Malta to promote Dublin’s bid for the European Medicines Agency (EMA) and a number of bilateral meetings with

his counterparts in other Member States were organised. “The EMA is facing a number of challenges in the light of Brexit, chief among which is the likely significant loss of expert staff and disruption to its operations. The loss of expertise in particular could severely impact the vital work undertaken by the Agency,” the Minister said. “It is vital when considering the matter of relocation that we first and foremost agree on a sustainable solution for the Agency, for Europe and above all else, for patients. “I am absolutely convinced that relocating the EMA to Dublin is the best choice in this regard. I say this not only for Dublin or Ireland but as genuinely the best choice for Europe.” The Minister highlighted the many advantages; • Firstly, I believe it will prove to be a popular location for current and future staff, thus contributing to the retention of expertise within the EMA. As I noted, the retention of expertise is a vitally important issue in the context of relocation. • Ireland’s national medicines agency, the Health Products Regulatory Authority, already provides significant support to the EMA and this can be rapidly scaled up in the event of relocation.

• When it comes to office accommodation and hotel accommodation, Dublin has the infrastructure to meet EMA requirements, with significant development on both fronts in the pipeline over the next 2 – 3 year period. We have identified a number of possible office solutions, two of which are detailed in our brochure, one in the North Docklands adjacent to the city centre and the second in a vibrant new commercial district at Dublin Airport. These are world class office solutions that can accommodate all EMA requirements and will be available to the EMA by 2019. Dublin is a growing city and in terms of world-leading organisations the EMA would find itself in extremely good company should it choose to relocate to Dublin. “I have already said that I believe that it is in the best interests of the EMA that there is an early decision on the new location, in order to provide certainty to staff and allow sufficient time for a smooth transition. I think it is also worth remembering that we are not talking about the establishment of a new agency, but rather the relocation of an existing, wellfunctioning organisation which has gained a reputation for excellence within the global regulatory system over the last 20 years,” he added.

Mangan’s Pharmacy Cycle for Cancer The staff of Mangan’s Pharmacy Newbridge took part in a charity marathon relay, along with a few famous faces all in the name of supporting the Irish Cancer society, in May. Staff had 4 Hours to complete 26.2 miles on a treadmill and a bike. In attendance was Dermot Earley, CEO and president of the GAA GPA (GaelicPplayers Association), Ronan Sweeney (Kildare GAA) Daryl Flynn (Kildare GAA) “It was a great day, and all the money is going to a great cause,” said Elaine Amoroso, Mangan's Pharmacy, Newbridge, speaking to Irish Pharmacy News. “It came about because some of the fundraisers from Walkie Talkie are from the area and, so we just decided that we wanted to help out! “So, we had an event outside the Pharmacy to support Relay for Life in aid of the Irish Cancer Society. In total seven of us took part, all hopping on and off at different parts of the day! Everyone was tired by the end, but it’s for a great cause and everyone really got stuck in.” In total, the pharmacy managed to raise 700 euros, all of which will go directly to help the Irish Cancer Society.


Feature

Female health and the Pharmacy The area of female health is a complex and diverse area and it is a hugely important category in Pharmacy, as for many women, the pharmacy is their first stop when seeking out products for their health, both intimate and otherwise. This article is centred around a number of specific areas that are particularly relevant to pharmacists who treat patients in community pharmacies.

also very important for pharmacists to inform their patients that there are also alternatives to OTC medications when dealing with symptoms of PMS.

Many of the issues that female patients present with in Pharmacy are sensitive issues and they will need to be dealt with in an open yet delicate manner, so it is important that a pharmacist know what they are, and the best method of treating them.

The alternatives such as advice on lifestyle and diet changes to alleviate symptoms, should be discussed in private with the patient.

Below, Irish Pharmacy News outlines some of the ailments that women with period or fertility problems, or reproductive health issues are likely to be experiencing if they present to a pharmacy. Period problems Problems in a woman’s menstrual cycle, called menstrual irregularities, are commonplace. Periods may be too regular, to infrequent, or event unpredictable or painful. If not caused by pregnancy, these menstrual irregularities may be a sign of a gynaecological condition or problem. Premenstrual Syndrome (PMS) There are many conditions that cause period problems with one of the most common problems being premenstrual syndrome (PMS). PMS refers to a collection of physical, psychological and emotional symptoms related to a woman’s menstrual cycle. Symptoms include abdominal bloating and cramps, breast tenderness or swelling, stress or anxiety, headache, joint or muscle pain, fatigue, irritability, and mood swings. Most women with PMS (about 80%) experience one or more of these symptoms at some point. Symptoms generally disappear before the menstrual cycle begins, however an estimated two to five percent of experience significant premenstrual symptoms characterised by severe mood swings and other symptoms related to emotions. It is important that when a pharmacist is helping a patient with PMS they treat the patient with care and understanding. It is

In addition, a pharmacist may recommend natural supplements like vitamin B6 and omega oils like Krill oil, which have been shown to be very beneficial in treating PMS related symptoms. Amenorrhoea This refers to the absence of menstrual periods in a woman during her reproductive years. Amenorrhoea is either classified as either ‘primary’ (menstrual periods not having started by age 16 years) or ‘secondary’ which is the absence of menstrual periods in a woman who has previously been menstruating for six months or more.

Like amenorrhoea it is not a disease but it is a symptom of a larger condition e.g. Polycystic ovary syndrome (PCOS). Again, the patient should be referred to her GP in cases such as this. Dysmenorrhoea It is common for women to experience an ache in their lower abdomen, back and tops of the legs, especially in the first few days of your period, known as Dysmenorrhoea. The first two days are usually the worst. Some women have more pain than others. Pharmacists can give a patient painkillers or anti-inflammatory painkillers such as ibuprofen usually ease the pain if it is troublesome.

The frequency of primary amenorrhoea in the population is about 0.5-1.2%, while the frequency of secondary amenorrhoea is approximately 5%. Patients may have headaches, visual disturbance or tiredness caused by diseases affecting the pituitary gland in addition to the absence of menstrual periods.

It is important to note, however, that sometimes dysmenorrhoea may be caused by infection, endometriosis, fibroids or ovarian cysts.

Amenorrhoea can be caused by a number of factors in a woman’s life including excessive exercising, an eating disorder, severe stress, hormonal or genetic problems.

Treatment must be tailored to the specific problem; therefore, a definite diagnosis must be made.

Oligomenorrhea Oligomenorrhea is a condition in which a woman experiences infrequent menstrual periods, and occurs in women of childbearing age. Some variation in menstruation is normal, but a woman who regularly goes more than 35 days without menstruating may be diagnosed with oligomenorrhea. Periods usually occur every 21 to 35 days.

The most common result of this is infertility. Sometimes Primary Ovarian Insufficiency is referred to as premature menopause, but the two conditions aren’t the same. Women with premature

The cause of the pain in most women is not fully understood. Sometimes conditions such as endometriosis can make period pains become worse. Pharmacists should advise women suffering from Dysmenorrhoea to see a doctor if:The pain becomes gradually worse each period; Pain begins a day or more before the onset of bleeding; Pain is severe over the whole time of the period.

Treatment depends on the underlying cause and it is usually advisable to refer the patient to her GP for further investigation.

insufficiency — is a loss of normal function of a woman’s ovaries before age 40. If their ovaries fail, they don’t produce normal amounts of the hormone oestrogen or release eggs regularly.

Menorrhagia Menorrhagia refers to abnormal or heavy bleeding which is different to normal menstrual bleeding. Typically a hormone imbalance the cause of menorrhagia, particularly in adolescents and women approaching the menopause. It is advised that pharmacists refer patients to a GP if they present experiencing Menorrhagia. Primary Ovarian Insufficiency Premature ovarian failure — also known as primary ovarian

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Feature The most effective oral contraceptive on the market is Ulipristal Acetate (ellaOne), which has been demonstrated to be effective up to 120 hours after unprotected sexual intercourse, and which acts by modifying the activity of the natural hormone progesterone which is necessary for ovulation to occur.

ovarian failure can have irregular or occasional periods for years and might even become pregnant. Women with premature menopause stop having periods and can’t become pregnant. Restoring oestrogen levels in women with premature ovarian failure helps prevent some complications, such as osteoporosis, that occur as a result of low oestrogen. Women with POI may have no periods or may get them infrequently. If a patient presents in Pharmacy with symptoms relating to POI then referral to her GP is advisable as in some cases oestrogen replacement therapy will be prescribed. Female infertility Female infertility is also common for women to present to a pharmacy with. Both a lack of ovulation, or infrequent ovulation are the two most common problems when it comes to female infertility. These can be caused by PCOS, POI, hypothalmic amenorrhoea, or pituitary gland problems. If a woman is experiencing pituitary gland problems it means that their glands are releasing too much prolactin, which is a hormone that affects oestrogen levels. Age is also a major factor when it comes to infertility, as the number of eggs produced by a woman’s body decreases as she gets into her 30’s. In addition, female infertility can be as a result of tubular blockage, endometriosis or male factor infertility. Other hormone related conditions such as an underactive thyroid gland, diabetes, obesity and occasionally Cushings syndrome can affect female fertility. Problems with Ovulation may be treated using fertility drugs such as FSH or LH, which work like natural hormones and help to bring it about. Pharmacists prescribing drugs to women experiencing ovulation

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problems typically choose clomiphene, gonadotropin therapy, human chorionic gonadotropin (Hcg), bromocriptine or cabergoline. PCOS, along with causing period problems, is also a major cause of female infertility. Women with PCOS have increased androgen (male hormone) levels, leading to an imbalance in the hormones that regulate ovulation and normal egg development. Signs and symptoms include an irregular menstrual cycle, excessive hair growth on the face and body, and obesity. Treatment of PCOS can vary from patient to patient, but a woman’s ovulation cycle can be restored in many cases through a combination of medication and lifestyle changes. Some women can become pregnant after they have been diagnosed with POI, however this is unlikely. Contraception options The pharmacy is the first stop for women who are looking for contraception. Over half of all pregnancies are unplanned, so it is important that both women and men are made aware of the various contraception options that are available to them. Women who awish to avoid an unplanned pregnancy can be advised by their pharmacist to use condoms, a contraceptive implant, intrauterine system (IUS), an intrauterine device (IUD), progestogen-only pill, or a diaphragm or cap. The most effective method of contraception is the IUD; however, a woman must be referred to her doctor for this.

Although it is advised that women should not use emergency contraception frequently, providing emergency contraception is nonetheless an integral service provided by pharmacists with regard to women’s reproductive health, and pharmacists should be aware of the products and options available to women. Last month, Minister for Health Simon Harris announced that medical card holders would now have access to emergency contraception without a prescription, ending what the Irish Pharmacy Union (IPU) called a ‘two-tier system’. It is expected that this will result in greater compliance and less unplanned pregnancies. Pharmacists had been allowed to supply the emergency contraception to women without a prescription since 2011. Pregnancy When a woman is pregnant, she can experience extreme discomfort at times, and a pharmacist can suggest or supply products to ease her pain or distress. Nausea and vomiting often develop by five to six weeks of pregnancy. The symptoms are worst around nine weeks, and typically improve by 16 to 18 weeks of pregnancy. However, symptoms continue until the third trimester in 15 to 20 percent of women and until delivery in 5 percent of women. To ease the symptoms of nausea, a pharmacist can suggest dietary changes, or a number of products. Vitamin B6 or antihistamines are often helpful for pregnancy women with mild to moderate nausea. If the nausea and vomiting is triggered by gastrointestinal distress, OTC reflux medications like Zantac or Pepcid can sometimes be effective.

Pharmacists may also provide emergency contraception to women have recently had unprotected sex in the form of the morning after pill.

It is advised that pregnant women avoid smoking cigarettes, as they could be harmful to their baby – pharmacists can suggest smoking deterrents, such as nicotine replacement therapy to a patient.

Although IUD is most effective, many women prefer not to have to be subject to invasive treatment, preferring to take a pill.

There are many products that women cannot take while pregnant, as they will cause harm to her foetus.

If a woman who is pregnant has cold or flu, it is very important that pharmacists do not give cold remedies that contain alcohol, or the decongestants pseudoephedrine and phenylephrine, which can affect blood flow to the placenta. Pharmacists can also suggest Folic acid for foetal health, as it helps prevent neural tube birth defects, which affect the brain and spinal cord. Neural tube defects develop in the first 28 days after conception, before many women know they are pregnant. It is also recommended that any woman who could get pregnant take 400 micrograms (mcg) of folic acid daily, starting before conception and continuing for the first 12 weeks of pregnancy. Menopause Menopause is the time in a woman’s life when menstruation stops and she can no longer conceive. A woman is said to have experienced the menopause when she has had twelve consecutive months without a period. On average, the menopause occurs when a woman is 51 years of age, but this varies quite a bit. The premenopausal, or perimenopausal, process usually begins in or around the early 40’s. Symptoms of this include hot flushes and night sweats, mood swings, vaginal dryness, diminished sexual desire, forgetfulness, trouble sleeping and urinary incontinence. After a woman has experienced the menopause her body produces less of the female hormones oestrogen and progesterone. Symptoms of the menopausal transition can be very troubling for many women, with many doctors prescribing hormone therapy (HRT, HT, ERT, ET) to ease symptoms. Many different types of hormone therapies are available for a pharmacist to give to a patient. These include tablets, patches, gel, vaginal preparations and nasal sprays. A pharmacist should discuss the available options for a patient privately with them. A pharmacist can also discuss with the patient some alternatives to hormone replacement therapy e.g. regular exercise, dietary changes, natural supplements like soy isoflavones and omega oils etc. They should also advise a patient see their doctor, if they are to make an informed decision about further treatment.


Feature

Pharmacists prepare for hay fever season As the weather gets better, the pollen count begins to increase, triggering allergies for thousands upon thousands of Irish people. Drier, warmer and less windy days allow pollen to build up, resulting in a higher pollen count.

developing an increased sensitivity, such as being exposed to animal fur or cigarette smoke.

Hay fever affects 1 in 5 people in Ireland and involves an allergic reaction to pollen from trees, grasses and flowers.

Symptoms

An estimated 80% of people with asthma are at increased risk of having an attack because they also suffer from hay fever, and an estimated 87% of hay fever sufferers experience sleep deprivation as a result of their symptoms.

 Itchy throat, inner ear or mouth

Types of pollen There are over 30 types of pollen and 20 types of spores that are known to trigger seasonal allergic rhinitis. Of all of these, grass pollen and tree pollen are the most common. In addition, other environmental factors can contribute to patients

Nasal rinsing Saline Air Purifiers Probiotics: Pollen filter Oral desensitization Hayband

Symptoms of seasonal allergic rhinitis include:

 Headaches  Loss of concentration  Sleep disturbance  Sneezing  Itchy, blocked or runny nose  Red, itchy or watery eyes Common problems of allergic rhinitis Nasal polyps Nasal polyps are fleshy swellings that grow from the

lining of the nose or sinuses, caused by inflammation of the membranes of the nose. A nasal polyp is shaped like a teardrop and looks like a grape on a stem when fully grown. They can grow individually or in clusters and usually affect both nostrils. If the polyps grow sufficiently large or in clusters they can interfere with the patient’s breathing, resulting in a reduction in a sense of smell and blocked sinuses/sinusitis. Smaller polyps can often be shrunk using corticosteroid nasal sprays but larger polyps may need to be surgically removed. There is an additional danger, however that if the sinuses become blocked with mucus, they may become infected with bacteria

become filled with mucus, the fluid will drain away. However, if the fluid is unable to drain away because of a blockage, it can become infected with bacteria. Initially, sinusitis can be relieved by regular, overthe-counter painkillers, such as paracetamol, ibuprofen or aspirin but ibuprofen is not recommended for asthmatics or those who have stomach problems, such as ulcers. Antibiotics may be recommended by a GP if the patient develops a secondary infection but chronic sinusitis may require surgery.

Sinusitis

Many allergy sufferers will have exhausted some of the more obvious options (the first line Antihistamines, Sodium Chromoglycate and OTC Corticosteroid Nasal Sprays).

A common complication of allergic rhinitis is sinusitis. Normally, when the sinuses

Here are some alternatives, for patients who ‘have tried everything’

While these are best known for treating chronic congestion, they can also be valuable in hay fever. Sinus rinses can eliminate allergens and other irritants from the nasal passages. A salt-based air purifier can give people a protected environment to retreat to. Since bacteria are involved in the risk of sensitization, there is also some evidence that they will help dampen the inflammation related to hay fever Your car engine has an air filter. So does the passenger area – often located behind your windscreen wipers. A DIY replacement costs less than €30. Grazax provokes formation of IgG antibodies which bind more quickly to the grass pollen proteins than IgE, blocking take-off of a full IgE allergic reaction. The acupressure-based elbow button works remarkably well for a proportion of sufferers


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Feature Fortunately nature has a simple answer to help ease the nasty symptoms of hay fever. Top tips for pharmacists to give to patients: 1. Cut out the caffeine and go for an anti-inflammatory green or white tea in case of blocked or runny nose. Caffeine triggers histamine release which can bring the skin up in a red, itchy rash until everything feels inflamed.

Sneezing Season Natural reliefs and top tips to help you get through the hay fever period While most of us are embracing the longer evenings and the warmer spring/summer air, the discomfort is only beginning for the 15-20% of hay fever sufferers in Ireland. Also known as seasonal allergic rhinitis, hay fever is an allergic reaction to air borne substances, such as tree, flower and grass pollen, that

get into the upper respiratory passages. Our immune system reacts to this foreign substances which results in the release of a compound called histamine. Histamine, when produced in excess, can irritate the upper respiratory passages, causing swelling and inflammation that produce the most common hay fever symptoms, including itchy and watery eyes, a blocked up or runny nose, frequent sneezing and coughing.

2. Reduce the sugar. Refined sugar triggers a dramatic rise and fall of blood sugar levels, which causes an adrenalin surge that activates histamine release. Opt for sweet dried or fresh fruit for a natural sugar fix instead. 3. Topping up on Vitamin C acts as a natural antihistamine. Fill your diet with fresh fruit and vegetables. Suggestions include blueberries, blackberries, purple grapes, mangoes, apricots, peaches, nectarines, papaya, pineapples, prunes, plums, raisins, figs, avocadoes, carrots, broccoli sweet potatoes, pumpkin, butternut squash, spinach and peas.

4. Dry clothes in-doors as damp clothes on the washing line will collect pollen and undress in the bathroom (not the bedroom) so the pollen from clothes doesn’t float around the bedroom. 5. Spread Vaseline around the edge of each nostril to trap or block pollen. Reapply each time you blow your nose. Pharmacist and Regulatory Affairs Officer Orla McCarthy, offered the following advice for managing hayfever symptoms. • Wear wrap-around sunglasses • Bathe or shower and change your clothing after being outside • Speak to your pharmacist about treatment options for managing your hayfever symptoms • Use an air conditioner at home and in the car • Avoid using fans that draw in air from outdoors • Don’t hang laundry outside to dry • Use a HEPA air filter in your bedroom

News Fancy a Change of Health Direction? LloydsPharmacy is inviting the public to take part in its Change Your Health Direction programme for summer 2017 — a free 8-week healthy living programme to help people improve their health during the summer months. The initiative is exclusive to LloydsPharmacy customers and available in all 94 stores nationwide. LloydsPharmacy experts will support customers who want to make a change to their health for summer 2017. The programme is flexible and convenient for customers, with many stores having late-night and weekend opening hours. The eight-week ‘health transformation’ programme includes weekly check-ins with a LloydsPharmacy coach, who tracks progress and gives free

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weekly advice and support to participants. Everyone that takes part has an initial ‘health check’ on their first meeting with their LloydsPharmacy coach. This involves a blood pressure and body mass index (BMI) check and a discussion about the individual’s health goals. Health transformation and smoking cessation programmes are then specifically devised for the participant to help them achieve their goals. Participants check-in with their local LloydsPharmacy coach

each week, at a day and time that suits them, to track progress and review their personal programme if needed. At the end of the eight weeks, customers receive a full report on their progress, as well as next steps to help sustain a healthier lifestyle in the long term. Following the success of January’s Change Your Health Direction programme, LloydsPharmacy has again teamed up with nutritionist, The Healthonist, who will share a variety of easy-to-make healthy recipes. These recipes will be available on LloydsPharmacy’s

LoveLloyds Blog and social media channels to help keep participants on track. Now in its third year, Change Your Health Direction is transforming the lives of LloydsPharmacy customers by helping them make better and more informed health choices. Since the start of the programme in 2015, LloydsPharmacy colleagues have coached their customers to lose a combined total of 10,134lbs, with customers losing a total of 3,966lbs in the eight weeks after Christmas this year alone.


Feature

What is Migraine? Migraine is more than just a headache. It is a complex, attacking neurological condition. Attacks last anything from a couple of hours to a few days. It is estimated that roughly 500,000 Irish people suffer from some form of migraine headaches. Migraine is three times more common in women than men with highest prevalence in women around age 40, then tailing off in the postmenopausal years. The precise cause of migraine is unknown; it relates to abnormal functioning of nerve cells that affect the brain’s ability to process information such as pain, light, sounds and other sensory stimulants. Common symptoms include: Migraine without Aura (around 80% of all attacks) • Moderate to Severe pain, throbbing one sided headache, aggravated by movement • Nausea and/or vomiting • Hyper sensitivity to external stimuli (i.e. noise, smells, light) • Stiffness in neck and shoulders • Pale appearance Migraine with Aura (in addition to above symptoms) • Aura, around 20% experience visual disturbances prior to the headache lasting up to one hour (most commonly, blind spots, flashing light effect or zig zag patterns; may include physical sensations such as unilateral pins and needles in fingers, arm and then face) • Blurred vision • Confusion • Slurred speech • Loss of co-ordination Migraine and the Pharmacy Irish Pharmacy News caught up with Debbie Hutchinson. Communications Manager for the Migraine Association of Ireland, to discuss the oftenmisdiagnosed condition, and

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some of the treatment options for Pharmacists dealing with patients who have presented with a migraine. “Pharmacists are on the front line and are very important in terms of treating people with migraines, so it’s very important for a patient to have a conversation with their pharmacist,” she says, speaking to Irish Pharmacy News. “Going forward, we’re in the process of creating a set of protocols which we are hoping to distribute to pharmacists, and OTC staff, so that they can be aware of best practice, and the options available for treating people suffering from migraine.” Different Headaches “A tension-type headache would be the most common kind of headache that people would get. Like so if you’re at the computer all day. It reacts well to over the counter medicines, and is relatively easy to treat. Migraine is one of various types of headaches, which all need different treatments. These include Cluster Headache; New Daily Persistent Headache; Chronic Daily Headache; Chronic Tension Type Headache; Hemicrania Continua; Shortlasting Unilateral Neuralgiform Headache with Conjunctival Injection and Tearing (SUNCT); Short-lasting Unilateral Neuralgiform Headache with Cranial Autonomic Symptoms (SUNA); Thunderclap Headache; Ice Pick Headache; Sinus Headache and others. “Each of those different types of headaches demands a different type of approach,” she says. “So it’s important that medical professionals be able to distinguish between them.

She continues, “And the thing about pharmacists, in terms of helping people suffering from migraines, is that they are pivotal, because people don’t go to their GP, and they’re more or less managing their condition with over the counter medicines. So, they need to be aware of all of the options available for patients. “And with migraines, they can be difficult to identify: It’s a neurological disorder, and not necessarily even a headache. In fact, some people with migraines don’t get headaches at all. They can lose their vision, or have paralysis in their face. I was talking to a consultant neurologist the other day, and they were saying that when you look at someone suffering from a migraine under an MRA scan, it looks almost like an electric short in the brain.” Treatment tips for patients with migraines “There are also some supplements that are quite good; in fact, there are some natural supplements that have been shown to be just as effective as a preventative as the preventative medications. One of the key supplements is

magnesium, and B-Vitamins and folic acid as well. But magnesium is very, very effective in terms of actually preventing the migraines from happening in the first place. Migralief, and Excedrin, in terms of treating a migraine once it’s already began, would be the two most p¬opular drugs for migraine relief on the market that people seem to use. About the Migraine Association of Ireland The Migraine Association of Ireland is a registered charity (Registered Charity No. CHY 11252) which has been operating since 1994. They are a membership-based organisation consisting of people with migraine or other headache disorders and members of their family and friends. They speak on behalf of people with migraine to policy makers. This development has been recognised in the form of the ‘Irish Patient Association of the Year’ award and the ‘Best use of Information Technology’ national award for our website: www.migraine.ie.


Aspirin 250mg, Paracetamol 250mg, Caffeine 65mg film-coated Tablets

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CONTAINS PARACETAMOL. ALWAYS READ THE LABEL / LEAFLET Product Information: Please consult the summary of product characteristics for full Product Information. Excedrin 250 mg/250 mg/65 mg film coated tablets (acetylsalicyclic acid, paracetamol, caffeine). Indications: Acute treatment of headache and of migraine attacks with or without aura. Dosage: Maximum 6 tablets in 24 hours. Drink a full glass of water with each dose. Must not be used for a longer period or at a higher dosage without first consulting a doctor. Not for use in those under 18 years. Exercise caution in the elderly. Headache: 1 tablet; if needed an additional tablet can be taken. In case of more intense pain, 2 tablets. If needed, an additional 2 tablets can be taken. Allow 4 to 6 hours between doses. For episodic use, up to 4 days. Migraine: 2 tablets when symptoms appear. If needed, an additional 2 tablets can be taken, with 4 to 6 hours between doses. For episodic use, up to 3 days. Contraindications: Hypersensitivity to ingredients. Patients in whom attacks of asthma, urticaria, or acute rhinitis are precipitated by aspirin or other NSAIDs, e.g. diclofenac or ibuprofen. Active gastric or intestinal ulcer, gastrointestinal bleeding or perforation and in patients with a history of peptic ulceration. Haemophilia or other haemorrhagic disorders. Severe cardiac, hepatic or renal failure. Intake of >15 mg methotrexate per week. Third trimester of pregnancy. Warnings and precautions: Not to be taken with other products containing aspirin or paracetamol. Not to be used if vomiting occurs with >20% or bedrest is needed with >50% of migraine attacks. Seek medical advice if no migraine relief from first 2-tablet dose. Not to be used on >10 days per month for >3 months. Discontinue use in actual or suspected medication overuse headache; gastrointestinal bleeds or ulceration. Risk of bleeding could be enhanced by alcohol, NSAIDs and corticosteroids. Caution in undiagnosed migraineurs, or those with atypical symptoms, exclude other neurological conditions; patients with dehydration, gout, impaired renal or hepatic function, uncontrolled hypertension, diabetes mellitus, severe glucose 6-phosphate dehydrogenase deficiency, alcohol dependence, hyperthyroidism, arrhythmia, bronchial asthma, seasonal allergic rhinitis, nasal polyps, chronic obstructive pulmonary disease, chronic infection of the respiratory tract, patients showing allergic reactions to other substances (e.g. cutaneous reactions, urticaria). May mask signs and symptoms of infection, increase bleeding tendency during/after surgery. Not to be taken with anticoagulant or other medicines that inhibit platelet aggregation unless under doctor supervision. Monitor in patients with defects of haemostasis. Caution in case of metrorrhagia or menorrhagia. May interfere with thyroid function tests. Caution in those taking liver enzyme inducers or potentially hepatotoxic medicines, or alcohol. Limit intake of caffeine-containing products. Pregnancy and lactation: Contraindicated in third trimester. Caution in 1st and 2nd trimester. Not recommended during breastfeeding. Side effects: Common: Nervousness, dizziness, nausea, abdominal discomfort. Uncommon: Insomnia, tremor, paraesthesia, headache, tinnitus, arrhythmia, dry mouth, diarrhoea, vomiting, fatigue, feeling jittery. Rare: Pharyngitis, decreased appetite, anxiety, euphoric mood, tension, dysgeusia, disturbance in attention, amnesia, coordination abnormal, hyperaesthesia, sinus headache, eye pain, visual disturbance, flushing, peripheral vascular disorder, epistaxis, hypoventilation, rhinorrhoea, eructation, flatulence, dysphagia, paraesthesia oral, salivary hypersecretion, hyperhidrosis, pruritus, urticaria, musculoskeletal stiffness, neck and back pain, muscle spasms, asthenia, chest discomfort. Not known: Hypersensitivity, anaphylactic reaction, Stevens Johnson syndrome, toxic epidermal necrolysis, restlessness, migraine, somnolence, palpitations, hypotension, dyspnoea, asthma, abdominal pain, dyspepsia, GI haemorrhage, GI ulcer, hepatic failure, hepatic enzyme increased, erythema, rash, angioedema, malaise, feeling abnormal. See SPC for full details. Legal category: Pharmacy only. MA number: 0030/059/001. MA holder: Novartis Consumer Health UK Limited, Park View, Riverside Way, Watchmoor Park, Camberley, GU15 3YL, U.K. Text revised: October 2016. Further information available on request. Reference 1: Lipton R et al. Efficacy and safety of acetaminophen, aspirin, and caffeine in alleviating migraine headache pain: three double blind, randomized, placebo-controlled trials. Arch Neurol. 1998;55:210-217. CHGBI/CHXCDRN/0005/16

Date of Preparation: November 2016.


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who took either a placebo or 4 capsules of sea buckthorn oil for a duration of three months. Typical dry eyes symptoms were soreness, dryness, grittiness, burning, redness, watery eyes or blurred vision. Omega 7 SBA24 significantly attenuated the increase in tearfilm osmolarity and influenced positively redness and burning symptoms in participants. Omega 7 SBA24 is generating interest amongst optometrists in the UK where it was presented at the key event Optometry Tomorrow in March. The NHS is now suggesting sea buckthorn oil may be effective in the treatment of dry eyes and blepharitis. INTIMATE DRYNESS - Vaginal dryness is a common yet distressing symptom of the menopause, brought on by declining oestrogen levels, which once kept the vagina supple and moist. During or after the menopause, about one in two women have symptoms related to atrophic vaginitis (vaginal dryness). In 2015, an empirical trial with 55 menopausal women looked at the results of Omega 7 SBA24 on vaginal atrophy and associated symptoms such as itching, burning and painful sex. Out of the 40 women who completed the study, 86% found improvements in vaginal dryness, 80% half way through the trial (six weeks). Of those suffering itching, 68% found relief, 76% of those with burning and 77% of those experiencing painful sex.

Omega 7 SBA24 not only promotes mucous membrane regeneration, important in protecting the internal organs from the environment, but also provides the nutrients essential for the proper functioning of the mucous membranes in the vaginal tract providing support also for women suffering from urinary tract infections (UTIs) and bladder problems. Unique formulation and extraction method Omega 7 SBA24 contains the oils from both the seeds and the pulp of the sea buckthorn berries which ensures the rich nutritional profile of the berries is maintained. The oil is extracted through an environmentally friendly, solvent free CO2 process which ticks all

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United Drug Pharmacy Show United Drug: A brief history A HISTORY OF INNOVATION The United Drug Chemical Co. was established in 1948, in the small Irish town of Ballina, by a group of pharmacists determined to find a more reliable supply of medicines. The first big victory came in 1950, when the pharmacists convinced Parke-Davis (which later became Pfizer) to bypass uncooperative Dublin wholesalers and supply them directly from London. The agreement set the scene for further expansion along the west coast of Ireland. In the late 1960s and early 1970s – a time of great upheaval for healthcare in Ireland – United Drug acquired a foothold in Dublin with the purchase of Ayrton Saunders. It meant we became a national distributer, competing on a much larger scale.

EXPANSION AND GROWTH The next three decades saw further expansion and innovation. In 1976 they became the first company in Ireland to run all systems by computer. In 1986 offered the first overnight service to pharmacists. In 1989, newly listed on the Irish Stock Market, they established UniDrug Distribution Group, a joint venture with Alliance Healthcare (now part of Boots). The company became the UK’s market-leading pre-wholesaler. United Drug Sangers was originally known as Thomas McMullan and Co., a retail pharmacy that opened in Belfast in 1860. The name was changed to Sangers (Northern Ireland) Ltd in the early 1980s, and the company joined the United Drug Group in 1992 It meant that, for the first time, they were able to distribute over the whole of Ireland. In 1999 United Drug joined forces with Dublin Drug – a move that saw them become the largest Irish wholesaler in the market.

United Drug announces ¤40m investment in innovation at Dublin HQ United Drug has announced a €40m investment in technology and innovation at its headquarters at Citywest, Dublin. The announcement, which was made at United Drug’s annual Pharmacy Show, will increase distribution by almost two-thirds, with plans for further expansion over the next three years. Last April, United Drug was acquired by McKesson Corporation. Currently ranked 5th on the FORTUNE 500, McKesson is a leading international healthcare services and information technology company with over 77,000 employees worldwide. Today’s investment announcement centres on enhancing systems and technologies at United Drug’s Dublin headquarters to further support the business in providing best-quality healthcare solutions to pharmacies, who, in turn, can focus on delivering the same to their patients. Work on phase one of the ¤40m investment - an upgrade of United Drug’s 300,000 sq ft warehouse facility, including state-of-the-art automation – has just completed. Already, this has exceeded

expectations in quality, accuracy and efficiency. Phase two involves an upgrade of the warehouse’s temperature control, or HVAC, system, as well as enhancements of its IT systems, including digital services and data analytics. This is expected to be completed by the end of 2017. United Drug has also indicated its commitment to further expanding its capacity over the next three years. Speaking at the Pharmacy Show, Paul Reilly, Managing Director at United Drug, said, “As the number one pharmaceutical wholesaler in Ireland, our investment in technology, particularly automation, is critical to maintaining our high operational and quality standards in terms of stock range, customer service and delivery. “At any one time, we have 30 million packs in our Dublin warehouse. We run a huge operation that, for the more than

1,800 pharmacies we serve – many twice a day – it’s important that operations are as tightly scheduled and as efficient as possible to ensure that important medicines reach patients when they need them. “Our systems are more technologically advanced than our competitors, and, despite the tough and challenging market we operate in, we will continue to invest and innovate so as to provide a sustainable healthcare platform for our customers and maintain our strong track record. “That we have more than doubled our efficiency over the past two years, and are already seeing a return on this latest investment, means that our customers can continue to get the excellent service that they have come to expect from United Drug, and more.” United Drug employs more than 650 staff across its four facilities: Magna Park, Swords, Ballina and Limerick.

Attendees lauded the efforts and attention to detail of the United Drug organising committee

Brendan Dunne, Michael Green and Keith Duggan, PHI

Daniel Byers, Paul Nash and Ben Tighe, KRKA

Fiona Taylor, Tom Smith and Kathleen Duffy, Bayer Ltd

Gary Walker, Clonmel Healthcare, Delores Shanahan, O Connor Pharmacy and Liam Daly, Clonmel Healthcare

Gerry Redmond, Dolmen Systems

Today they are known as United Drug and their ambition is to keep improving, to expand into niche areas of specialist distribution and to continue to grow their share of the market.

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Continued on page 44


Supporting you through the

Menopause

Menopause Support Herbal food supplement with Soy Isoflavones, Magnesium and Hibiscus for support before, during and after the menopause. Contains magnesium which contributes to a reduction of tiredness and fatigue. Menoforce sage tablets Active Ingredients: One tablet contains 51 mg of dry extract from fresh Sage (Salvia officinalis L.) leaves. Indications: Traditional herbal medicinal product used for the relief of menopausal hot flushes and excessive perspiration exclusively based on long-standing use. Dosage and administration: Adults (18 years and over): One tablet daily. Not indicated in patients less than 18years. Contraindications: Hypersensitivity to sage preparations or any of the ingredients. Warnings and Precautions: If symptoms worsen or do not improve after 12 weeks, consult a qualified healthcare professional. This product may affect your ability to drive or use machines. If you are affected do not drive or use machinery. Contains sucrose. Pregnancy and lactation: This product should not be used during pregnancy and lactation. Side effects: No undesirable effects have been reported. Legal category: GSL. Registration Number: TR725/4/1. Registration holder: Bioforce (UK) Ltd, 2 Brewster Place, Irvine, Ayrshire KA11 5DD UK. Date of Preparation: November 2013.

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United Drug Pharmacy Show

Continued from page 42

Graham Stafford, Richard Cronin and Brian Kissane, Ocean Healthcare

Jean Meagher and Nikki Dunne, L’Oreal

Jim Curran, IPU. Anthony O’Neill, Clarity Locums and Claire Timmon, Clarity Locums

Kian Coleman and Cian Croghan, Johnson and Johnson Ireland Ltd

Nicola Browne and Andrew Maher, Pharmaher Healthcare

Peter Brennan, Original Beauty Ltd

Perrigo shines at The UD Pharmacy Show 2017 On Perrigo’s first appearance at the UD Pharmacy Show since it acquired Omega Pharma in 2015, the company brought a shine to proceedings as it showcased its market leading brands, including NiQuitin, Bronchostop and Solpadeine. Already a major manufacturer of private label goods and OTC branded generics, Perrigo’s acquisition of Omega Pharma has propelled it into major player status in branded consumer health products across the UK and Ireland. Creativity, innovation and a sense of fun lie at the heart of Perrigo’s service ethos, all of which were delivered in abundance at the show, from arrival to the Aviva with ‘Extrails’ brandishing teasers and matching replica-styled cardboard cut-out for signpost leading to a pharmacy window at their suite. Perrigo’s commitment to support its brands through training, NPD and marketing, was very much in evidence at the stand, underscoring its commitment to being the fastest growing brand across its chosen sectors. John Sheehy, Perrigo’s Country Manager for Ireland, joined the sales and marketing team of 1o

at the show. “We were delighted to be a big part of the UD event this year and delighted with the response received from those who visited the suite to see the work we are doing in the Irish market. Our core principle in business is to lead through innovation, training and education and that must be based on excellent relationships with customers. This event provided us a fantastic opportunity to reaffirm that with pharmacists from across the country.” Founded in 1887 by Luther Perrigo in Allegan, Michigan, USA, Perrigo further extended into the European consumer healthcare landscape with the acquisition of Omega Pharma across Europe, including the UK and Ireland, in 2015. Now headquartered in Dublin, the company is a top five global OTC pharmaceutical company committed to working and partnering with pharmacies to drive growth with its leading pharmacy only brands.

Some of the Perrigo team at The UD Pharmacy Show 2017 (left to right) - Fiona Clancy, Niall McMorrow, John Sheehy, Brendan O’Keeffe, Geraldine Mangan, Paul Hatton, Amanda Quinn, Shane Tyrell, Anne Marie O’Neill and Niall Faul.

Small Businesses among big players “Original Beauty Ltd was happy to participate in the United Drug Pharmacy show to present our skin, body and hair care brand Ziaja. The show gave us the opportunity to display the full range of the brand, of which the Goat’s Milk line is the most popular and successful on the Irish market. Presently we have 100 products for all age groups and skin types available to pharmacies through United Drug Consumer – Pemberton. The show was very successful for us as we got to meet our existing customers and show them new products available as well as we gained a good number of new customers who were familiar with Ziaja and wanted to stock the brand. Both were impressed with the variety

44

of the range and the appealing, consistent design. Our new Brazilian nut range Cupuacu and the Baby & Kids range were big hits with the pharmacy buyers. The combination of the high quality of the products and reasonable price was what they were amazed by mostly. Offering attractive show discounts made our dear customers even happier. The high interest in our brand has proven

to us that there is a demand on the Irish market for high quality products at retail price below ¤9.99.

us to spread the word of the great brand Ziaja throughout the Irish market.

Last year we joined forces with Pemberton to make access for pharmacies to stock Ziaja easier. It was a very good decision as the cooperation works smoothly and efficiently due to the professionalism and kindness of Pemberton staff. We hope more and more pharmacies will help

The show itself was very well run from set up to take down. The organisation was perfect and the staff very helpful. That’s why the 3 days spent at the show were stress-free, efficient and fruitful. “We will be there next year for sure,” said Peter Brennan, Original Beauty


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Doublebase™ Emollient Gel Therapeutic ingredients: Isopropyl myristate 15% w/w, liquid paraffin 15% w/w. Presentation: White opaque gel. Uses: Highly moisturising and protective hydrating gel for regular and frequent use in the management of dry skin conditions such as eczema, psoriasis or ichthyosis. Directions: Adults, the elderly, infants and children: Apply directly to dry skin as often as needed. It may also be applied before washing, showering or bathing to prevent further drying of the skin. Contra-indications, warnings, side effects etc: Do not use if sensitive to any of the ingredients. In the rare event of a reaction stop treatment. Ingredients: Isopropyl myristate, liquid paraffin, glycerol, carbomer, sorbitan laurate, trolamine, phenoxyethanol, purified water. Pack size and trade price: 100g tube €3.42. Legal category: Class I medical device. Further information is available from the manufacturer: Dermal Laboratories, Tatmore Place, Gosmore, Hitchin, Herts, SG4 7QR, UK. Date of preparation: November 2016. ‘Doublebase’ is a trademark.

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Pictorial

Perrigo at The UD Pharmacy Show 2017 The Perrigo suite was a hive of activity over the three-day event as pharmacists from all over the country visited the team to discuss plans for the company’s market-leading OTC brands.

46

John Sheehy, Country Manager – Ireland, Perrigo and David Keyes, Distribution and Hospitals Director, United Drug

Some of the Perrigo crew at The Pharmacy Show 2017 (left to right): Alan Harnett, Shane Tyrell, Fiona Clancy, Niall McMorrow and Paul Hatton

Niall Faul, National Pharmacy Sales Controller, Perrigo; Mark Lambe, Head of Procurement, Lloyds Pharmacy and John Sheehy, Country Manager – Ireland, Perrigo

Paul Hatton, Perrigo with Deborah McCarthy and Catherine Power, O’Connor’s, Bishopstown, Co Cork

Amanda Quinn, Perrigo (centre) with Philippa Galligan (left) and Yvonne Lee, City Pharmacy, Dame Street, Dublin

Edel Marron, Marron’s Pharmacy, Clane, Co Kildare and Ollie Higgins, Perrigo

Carol Gallego and Mark O’Flaherty, Strand Street Pharmacy, Skerries, Co Dublin with Alan Harnett, Perrigo

Jennifer Valentine, Perrigo and Bláithín O’Brien, Dalkey Pharmacy, Co Dublin

Anne Marie O’Neill, Perrigo, Mary Doyle, Doyles Pharmacy, Athy, Co Kildare and Alan Harnett, Perrigo

Amanda Quinn, Perrigo and Shay Bonomally, Lawlors, Bray, Co Wicklow

Ollie Higgins, Perrigo with Ciara Galvin and Karen Whoriskey, Abbeydorney Pharmacy, Tralee, Co Kerry

Jennifer Valentine, Perrigo and Jonathon Morrissey, Marron’s Pharmacy, Clane, Co Kildare

Alan Harnett, Perrigo and Aaron Carlyle, Chemist Connect Bridgend, Donegal

Norma Doran and Fergal Sheridan, Dorans Pharmacy, Listowel, with Brendan O’Keeffe, Perrigo

Amanda Quinn, Perrigo and Grace Cheevers, Medipharm, George’s Street, Dublin 2


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CPD 79: SKIN CANCER Biography - Amy Louise Oates. I qualified from the Robert Gordon University Aberdeen with a Master in Phamacy in 2011. I then undertook my pre-registration year with Gordons Chemists in Edinburgh. After registration I moved back home, where I am now working for Johnstons Pharmacy in Longford Town, Lanesborough and Ballygar, Co. Galway. I also recently completed a Cardiology in Clinical Pharmacy Practice module with Trinity College Dublin.

1. REFLECT - Before reading this module, consider the following: Will this clinical area be relevant to my practice. 2. IDENTIFY - If the answer is no, I may still be interested in the area but the article may not contribute towards my continuing professional development (CPD). If the answer is yes, I should identify any knowledge gaps in the clinical area. 3. PLAN - If I have identified a knowledge gap

- will this article satisfy those needs - or will more reading be required? 4. EVALUATE - Did this article meet my learning needs - and how has my practise changed as a result? Have I identified further learning needs?

Disclaimer: All material published in CPD and the Pharmacy is copyright and no part of this can be used within any other publication without the permission of the publishers and author.

5. WHAT NEXT - At this time you may like to record your learning for future use or assessment. Follow the 4 previous steps, log and record your findings.

Management of Skin Cancer and Melanoma Every year in Ireland over 700 new cases of skin cancer/melanoma are diagnosed and there are 100 melanoma related deaths. Over 60% of patients are female, with the risk of developing melanoma before the age of 75 is 1 in 78 for males and 1 in 80 for females. Skin cancer is the abnormal, uncontrolled growth of skin cells, developing when the genetic material - DNA inside skin cells is damaged, for example due to overexposure to ultraviolet (UV) radiation in sunlight or sunbeds, triggering changes that lead these cells to multiply rapidly and become cancerous. Skin cancer is the most common form of cancer in Ireland. In most cases it is preventable and early detection leads to better outcomes. The vast majority of these cancers are caused by overexposure to UV radiation, mainly from sunlight, although UV radiation from artificial sources (e.g. sunbeds) can also cause skin cancer. People who have used a sunbed, even just once, have a 15% increased risk of melanoma, the most serious type skin cancer. If you first use a sunbed before you were 30 years of age, your risk of getting melanoma is increased by 75%. If you use a sunbed once a month or more, your risk of skin cancer may be increased by more than half. There are two main categories: non-melanoma skin cancer (comprising of basal cell carcinoma and squamous cell carcinoma) and malignant melanoma. Of the two types of skin cancer, melanoma is not the most common but raises the greatest concern as it can spread to other parts of the body, where it becomes difficult to treat and can be fatal. Most people in Ireland have fair skin which burns easily and tans poorly, so are particularly susceptible to sun damage and skin cancer. The most obvious warning sign of skin cancer is a change in the

Published by IPN. Copies can be downloaded from www.irishpharmacytraining.ie

appearance of the skin, such as a new growth, a sore that will not heal, a new and changing mole, or the change in appearance of an existing mole. RISK FACTORS • Atypical moles • A large number of mole (>50)

60 Second Summary Skin cancer is the most common form of cancer in Ireland. The numbers are rising each year with more men than women being diagnosed.

• Fair complexion (fair skin, blue eyes, red/blond hair)

Sun exposure is still the leading cause of skin cancer in the world today.

• A previous melanoma or non-melanoma skin cancer

There are two different types of skin cancer- non-melanoma and malignant melanoma. Non-melanoma is the most common, and comprises of Basal Cell Carcinoma and Squamous Cell Carcinoma.

• Sunbed exposure • Immunosuppression • History of childhood sunburn VARIETIES OF MELANOMA 1) Superficial spreading – horizontal growth pattern. Accounts for 60-70% of melanomas 2) Nodular – vertical growth pattern. Accounts for 15-30% of melanomas. 3) Acral + mucosal lentiginous – These do not appear to be linked to sun exposure. Mostly prevalent in Asian and Black ethnic groups 4) Lentigo maligna - an early form of melanoma in which the malignant cells are confined to the tissue of origin, the epidermis, it is often reported as ‘in situ’ melanoma. It occurs in sun damaged skin so is generally found on the face or neck, particularly the nose and cheek. It is the least common form of melanoma, generally in elderly patients aged over 70 years.

The most obvious warning sign of skin cancer is a change in the appearance of the skin, such as a new growth, a sore that will not heal, a new and changing mole, or the change in appearance of an existing mole. Treatment options depend on the nature and size of the tumour, but can included surgery, radiation therapy, chemotherapy or topical formulations. Most skin cancers can be prevented by limiting sun-exposure and the use of sunbeds. One of the best ways to protect the skin from sun exposure is to spend some time in the shade when the sun is strong. The sun’s UV rays are usually strongest between 11am and 3pm so it is important to protect the skin from sunburn during these hours.


CPD 79: SKIN CANCER

WHO IS AT RISK OF SKIN CANCER?

WARNING SIGNS FOR MELANOMA

BASAL CELL CARCINOMA

Although anyone can get skin cancer, there is a greater risk for people with fair or freckled skin that burns easily, light eyes and blond or red hair. Those with darker skin are at a substantially lower risk. As well as complexion, there are other risk factors such as a family history or personal history of skin cancer, having an outdoor job and living in a sunny climate, history of severe sunburns and the presence of large and irregularly-shaped moles. Albinism is an inherited genetic condition where the skin produces no melanin at all. Albino patients have very white skins and pale blonde hair and are at higher than average risk of skin cancer because their skin has no natural protection against the sun.

• Asymmetry—the shape of one half doesn’t match the other

Most common cancer in Caucasians, representing >75% of skin cancers.

• Border—edges are ragged or blurred

You risk of developing BCC is increased by:

• Colour—uneven shades of brown, black, tan, red, white or blue

• UV radiation

• Diameter—a significant change in size (greater than 6mm)

• Carcinogens (arsenic, ionising irradiation)

MAIN SYMPTOMS OF SKIN CANCER The most common warning sign of skin cancer is a change on the skin, typically a new mole or skin lesion or a change in an existing mole. • Basal cell carcinoma can present as a small, smooth, waxy bump on the face, ears and neck; or as a flat, pink, red or browncoloured lesion on the trunk, arms or legs • Squamous cell carcinoma can appear as a firm, red nodule, or as a rough, scaly flat lesion that can be itchy, bleed and become crusty. Both basal cell and squamous cell cancers mainly occur on areas of the skin frequently exposed to the sun, but can occur anywhere. • Melanoma usually appears as a pigmented patch or bump. It may resemble a normal mole, but usually has a more irregular appearance.

• Genetic predisposition

STAGING

• Immunosuppression

1) Breslow’s Staging system - classifies the tumour according to depth of invasion (thickness) – measurement of the depth of the lesion, measured vertically in millimetres from the top of the granular layer (or base of superficial ulceration) to the deepest point of tumour involvement. Breslow’s Depth of Invasion is the most important determinant of prognosis for melanomas

Epithelial tumours arising from undifferentiated skin basal cells may be:

2) Clark’s Level of local invasion– based on the level of tumour invasion relative to the layers of the skin.

• Ulcerative

Exposure to the sun no doubt has a number of benefits, it gives people an increased sense of wellbeing, provide ample opportunity for physical activity and enables people to synthesise vitamin D. 3 However, sun exposure, exposure to ultraviolet radiation (UV) is the leading cause of skin cancer. The incidence of skin cancer is increasing worldwide. There are two main types of skin cancer 1) Non-melanoma – Basal and Squamous cell cancer 2) Malignant melanoma

• Nodular • Pigmented • Sclerosing • Infiltrating SQUAMOUS CELL CARCINOMA Very common and increasing frequency. Risks include: • UV radiation • Carcinogens (arsenic, ionising radiation) • Inherited condition as for BCC • Marjolin’s ulcer • Chronic skin diseases • Areas of vitiligo SCC usually arise in sun-exposed areas such as the back of the hand, scalp, lip, and surface of the ear. The tumour grows relatively slowly,


CPD 79: SKIN CANCER

but unlike BCC, SCC has a risk of metastasis. The risk of metastasis is higher in SCC arising in scars or on the lower lips, and occurring in immunosuppressed patients. 2-5% metastasize to regional lymph nodes and more distantly if left untreated. These are the most common form of skin cancer and are caused by cells in the epidermis, the top layer of the skin. The function of the skin is to protect the body and vital organs from damage, to regulated body temperature and to rid the body of toxins and waste products by sweat. The top layers of the skin are made up of cells that have died and become filled with keratin. Keratin is made by keratinocytes, is a tough waxy substance that helps to make the skin strong enough to protect the body. Keratinocytes are the most

common type of cells found in the epidermis. Basal cells are a special type of keratinocyte and are found at the bottom of the epidermis. They are also the cells that basal cell skin cancers can develop from. Basal is the most common type of skin cancer. It is a nonmelanoma, easiest to treat and rarely fatal. However if it is not diagnosed early or is not properly treated it can result in tumours that can destroy important anatomical structures such as the eye, ear and nose. It is associated with intensive UV radiation exposure in childhood and adolescence, especially in those who burn easily. Squamous cell skin cancer also develops from keratinocytes in the epidermis. Squamous cell carcinoma is more serious and can be disfiguring and fatal if it spreads. Its development is also associated with chronic UV exposure

in the early decades of life. In the deeper layers of the epidermis there are cells called melanocytes. Melanocytes make melanin, a brown substance that is produced when the skin is exposed to the sun. Melanin helps to protect your skin against the harmful rays of the sun. It is melanin that makes fair skinned people tan in the sun. Melanocytes are more active in darker skinned people and make more melanin. Dark skinned people are more protected against skin cancer than fair skinned people. It is these cells that can become cancerous in melanoma. Malignant melanoma is the most serious and is responsible for the majority of deaths resulting from skin cancer. Episodes of severe sunburn particularly before the age of 18 years can lead to melanoma later in life.


CPD 79: SKIN CANCER

normal tissue. The tissue is immediately evaluated under a microscope and areas that demonstrate residual microscopic tumour involvement are re-excised and the margins are re-examined. This cycle continues until no further tumour is seen. This more complicated and expensive option is the treatment of choice for tutors where normal tissue preservation is vital, where the tumour margins are poorly defined, in tumours that have been previously treated and have recurred, and in certain high-risk tumours. Radiation therapy: Ten to fifteen treatment sessions deliver a high dose of radiation to the tumour and a small surrounding skin area. This form of treatment is useful in those who are not candidates for any surgical procedure. The advantage of radiation therapy is that there is no cutting involved. The disadvantages of this expensive alternative are that the treated area cannot be tested to be sure the whole tumour is gone and radiation scars look worse over time. It is for this reason it is usually reserved for elderly patients. INDICATIONS FOR RADIOTHERAPY DIAGNOSIS

• associated regional lymph node drainage area.

This is where the tumour area is numbed with a local anaesthetic and is repeatedly scraped with a sharp instrument (curette), and the edge is then cauterized with an electric needle. Advantages of EDC is that it is fast, easy, and relatively inexpensive. The disadvantages are that the scar is often somewhat unsightly, and the recurrence rate is as high as 15%.

A biopsy to confirm histology is essential.

SURGICAL EXCISION

Extent/depth of tumour determined by Inspection, Palpation and Imaging if necessary.

The area around the tumour is numbed with a local anaesthetic. A football-shaped portion of tissue including the tumour is then removed and then the wound edges are closed with sutures. For very big tumours, skin grafts or flaps are needed to close the defect. Advantages of surgery are that there is a greater than 90% cure rate, the surgical specimen can be examined to be sure that the whole tumour is successfully removed, and the scar produced is usually more cosmetically acceptable than that of the EDC procedure. It is a more complicated procedure and is more expensive than EDC.

Full general clinical examination of: • skin with a meticulous examination of lesions

TREATMENT There are many effective treatment options for skin cancer. The choice of therapy depends many factors, such as the location and size of the tumour, the microscopic characteristics of the cancer, and the general health of the patient. TOPICAL MEDICATIONS In the case of superficial basal cell carcinomas, some creams, gels, and solutions can be used, including imiquimod (Aldara), which works by stimulating the body’s immune system causing it to produce interferon which attacks the cancer, and fluorouracil (Efudix) a chemotherapy drug. Some patients do not experience any side effects of these topical treatments, but others may have redness, inflammation, and irritation. A disadvantage of topical medications is that there is no tissue available to examine to determine if a tumour is removed completely. Destruction by electrodessication and curettage (EDC):

INDICATIONS FOR SURGERY • Small lesions amenable to quick, simple excision • Younger pts where cosmesis might be better • Lesions close to or involving bone, cartilage, tendon, joint • Where there is uncertainty about disease extent • Lesions that recur after Radiotherapy Mohs micrographic surgery: The site is locally anesthetized and the surgeon removes the visible tumour with a small margin of

• Large superficial lesions where surgery would lead to poor cosmesis or morbidity • Multiple lesions • Recurrent lesions after surgery • Older patients • For those who refuse surgery/unfit for surgery Other types of treatments for skin cancers include cryosurgery where tissue is destroyed by freezing, photodynamic therapy (PDT) in which medication and blue light is used to destroy the cancerous tissue, laser surgery to vaporize (ablate) the skin’s top layer and destroy lesions, and oral chemotherapy. METHODS TO PREVENT SKIN CANCER One of the best ways to protect the skin from sun exposure is to spend some time in the shade when the sun is strong. The sun’s UV rays are usually strongest between 11am and 3pm so it is important to protect the skin from sunburn during these hours. Trees, umbrellas, canopies or buildings can all provide shade and help you protect your skin. Another method to protect the skin is to apply sun-screen with a sun protection factor (SPF) of 15 or greater 30 minutes before sun exposure and then every few hours thereafter. It is recommended to use a sunscreen that has good protection against UVA rays as well as a high SPF. This is because both UVB and UVA rays can cause skin cancer. Pa-tients can be advised to use cosmetic products and contact lenses that offer UV protection and also to wear sunglasses with total UV protection. It is also important to examine skin regularly to be-come familiar with existing growths and to notice any changes or new growths.


PAI

PHARMACY ASSIST IRELAND 2018

E D U C AT I O N T R A I N I N G D I R E C T O RY

IPN Communications Ltd will shortly be publishing Pharmacy Assist Ireland - the only Educational Training Directory delivered to every pharmacy in Ireland. Targeted to all Counter Assistants PAI has a readership of over 7,500 Training spreads, Advertising, Diary Branded Year Planners, IPN Communications Ltdbranding, will shortly be publishing Pharmacy Assist Irelandand is the onlymore Educational annual Branded Holiday planners much are available todelivered sponsors IPN Communications Ltd will shortly be publishing Pharmacy Assist Ireland the only Educational to every pharmacy Ireland.assistants upTraining This is a unique opportunity for you to bring in counter to speed on

Pharmacy -and onlyin Educational Training Directory delivered to Ireland every pharmacy Ireland. Targeted to all Targeted toCounter allAssist Counter Assistants - the PAIrecommend has a readership of over your brand. Assistants sell the brand they7,500 know. Directory delivered to every in Ireland. Targeted to all Counter Assistants PAI has a readership ofYear over 7,500Branded Itpharmacy is branding, FACT. OTC Training Guides, Advertising, Diary Branded Planners, Counter Assistants PAI has readership 7,500 Holiday planners much now available forover sponsors Training guides and for each ofmore, theacategories canof be booked

Training spreads, Advertising, Diary Branded Year Planners, in the 2018 PAIbranding, now on a first come fipublication. rst served basis. Brandedspreads, Holiday Advertising, planners andDiary much more areBranded availableYear to sponsors Training branding, Planners, Branded Holiday planners and to much more are available toup sponsors This is a unique opportunity for you bring counter assistants to speed on For further please contact:  Demonstrate how pharmacy staff details can recommend a product within your your brand. Counter recommend the brand know. This istoaMcGourty, unique opportunity for you toand bring counter assistants upthey to speed on Maeve Training,Assistants Education &sell Development Manager – Pharmacy Assist Ireland range treat a specific problem. It is FACT. your brand. Offi Counter Assistants sell and recommend the211751 brand they know. ce - (00353) 01 6690562 | Mobile - (0044) 7450  Promote knowledge of your brandIt– is Pharmacy Assistants are more likely FACT. Email- maeve.ipn@irishpharmacytraining.ie | www.pharmacynewsireland.com Training guides for each of the categories can be booked to recommend a product that they know. now on first come rst served basis. Training guides fora each of theficategories can be booked  Build and promote brand awareness now on a first come first served basis. For further details please contact: Maeve McGourty, Training, & Development – Pharmacy Assist Ireland ForEducation further details pleaseManager contact: For further details please contact Nicola or Barry on 016690562 OffiTraining, ce - (00353) 01 6690562 | Mobile - (0044) 7450 211751 Assist Ireland Maeve McGourty, Education & Development Manager – Pharmacy nicola@ipnirishpharmacynews.ie / barry@ipnirishpharmacynews.ie Email- maeve.ipn@irishpharmacytraining.ie | www.pharmacynewsireland.com Office - (00353) 01 6690562 | Mobile - (0044) 7450 211751 Email- maeve.ipn@irishpharmacytraining.ie | www.pharmacynewsireland.com


Awards The Irish Pharmacy

2017

Celebrating Excellence and Recognising Innovation

The sixth Irish Pharmacy Awards showcased the extraordinary talent and hard work community pharmacists are undertaking throughout the country during an evening of celebration at the Clayton Hotel, Dublin. The Irish Pharmacy Awards champions excellence in all aspects of the community Pharmacy sector and has proven to be the highlight of the year for the pharmacists, their teams, and industry, with over 650 in attendance. With over 1,500 community pharmacies across Ireland, these prestigious awards are certainly an acclaim to be proud of. Finalists were selected from over 100 nominations representing Ireland’s leading multiple and independent community pharmacies, alongside the chief buying and symbol groups, and their individuals and teams nationwide. All of these submissions are testament to the huge efforts community pharmacies and their teams are making to improve patient care. The entries were made towards a total of 17 Award Categories, reflecting all areas

of community Pharmacy from Business Development to Innovation, and from Self Care to Superintendent Pharmacist of the Year. These Awards strengthen the relationship between pharmacists and patients to provide the care and expert advice they deserve. By going above and beyond, pharmacists can help people live well, stay well and get well. Irish Pharmacy Award winners reflect the industry’s determination to revitalise and enhance their status within the wider healthcare arena. Through the submissions to these Awards and the examples of innovation that they demonstrate, pharmacists and their teams can benchmark their business and health and wellbeing practices against their colleagues and the profession in which they operate, as a whole. Whilst the short listing process was extremely difficult – with some strong entries failing to make it to the shortlist – it is important to highlight that it is not just about winners and losers. Everyone who entered this year’s awards deserves commendation.

Whatever my achievements for our Pharmacy, they are a result of working closely with the wider profession, and of course my team, to uphold a values-led Pharmacy profession

Eamon Brady, Whelehan's Pharmacy

CarePlus demonstrated success in their moves forward in the digital arena, winning the MSD Innovation & Service Development Award for a Chain, for their work developing a new App and Whelehan’s Pharmacy in Sligo inspired the judges to gain them the United Drug Business Development Award for an Independent. Over the following pages we feature the winners across the 17 Categories, alongside their category sponsors. Thanks must go to our esteemed judging panel, entrants, finalists, guests and of course sponsors. Without all of you, the growing success of the Irish Pharmacy Awards would not be possible. Make sure you catch the next issue of Irish Pharmacy News which will have exclusive case study coverage of all the winning entries.

I feel very inspired by all of the finalists - the whole event was a real celebration of Pharmacy at its very best. It made me very proud of my profession to listen to all of the fantastic work and incredible achievements that were described on the night from all over Ireland

Awards Guest

54

Winners on the night included Meaghers Pharmacy Group whose Barrow Street team won the Pharmacy Team of the Year Award, whilst Eugene Renehan took hom the Superintendent Pharmacist of the Year accolade.


Awards The Irish Pharmacy

2017

MSD Innovation & Service Development (Chain) Award 2017

CarePlus get Smart - The winner of this year’s MSD Innovation & Service Development (Chain) Award was the Careplus Pharmacy Group.

MSD Innovation & Service Development (Chain) Award 2017 presented by Mr Mick Phelan, Business Unit Director, MSD to Louise Doherty, Systems Innovation Manager and Finn McCann, Technology and Systems Director, CarePlus Pharmacy CarePlus Pharmacy released a Smart Phone App, which includes an information station for customers to look up advice on a range of health topics, a pharmacy store locator, a BMI calculator and order your prescription from your phone feature, as well as special offers information and much more. The order your prescription feature, which is the first of its kind in Ireland, allows patients to order their prescriptions without having to go to the pharmacy until they collect it, which makes the process much easier and convenient for customers. Using the App, customers simply select their local CarePlus

Pharmacy, take a picture of their prescription with their phone, add any additional information or notes for the Pharmacist and send it to their chosen CarePlus store. They also receive an alert on their phone to let them know when the prescription is ready for collection, saving valuable time when collecting medicines from the pharmacy. Accepting the award on the night, Finn McCann, Technology and Systems Director, CarePlus said, “We are delighted to have won the MSD Award and think it's a terrific endorsement of the work we have been doing over the past couple of years in innovation and helping

our CarePlus pharmacies become more proactive in the area of technology and the digital space in general. The App not only reduces waiting times for our customers, but importantly free's up the time a Pharmacist can spend with a patient and also drives efficiencies allowing the Pharmacist to prepare prescriptions during off peak hours.” Mick Phelan, Business Unit Director with MSD said, “MSD are very proud to sponsor an award which acknowledges innovation in Pharmacy, individuals and teams who have invested in the development of exceptional innovations which leads to an improved patient experience, such

as the CarePlus App and their implementation of the electronic shelf edge labels, which both affords the Pharmacist and front line staff more time with the customer.” “We strongly identify with this award as it is closely linked with our very special passion, which has driven the people of MSD to develop medicines, vaccines and animal health innovations that will improve the lives of millions around the world.” “Congratulations to the CarePlus Pharmacy team.”

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Awards The Irish Pharmacy

2017

IRISH PHARMACY NEWS

IPN Pharmacy Representative of the Year 2017

Sophie Scores in Representing Pharmacy - The winner of this years’ IPN Pharmacy Representative of the Year was Sophie Rickelton, of Pamex. Sophie travels around Ireland for her job as a Pharmacy Representative, doing her best to provide the same quality of service, and information, she says, to all customers, regardless of geographical location. Sophie was up against some stiff competition this year, with Amanda Hoover of Scope, and Luke Doherty of P.C.O Manufacturing, proving worthy competitors. Rickelton expressed her surprise, and delight at receiving the award on the night. Speaking to Irish Pharmacy News on the night of the awards, she said, “We’re quite a small company. There’d only be about ten or 11 of reps. My sales manager Diarmuid Gavin, we have developed a fantastic working relationship and he put me forward. “We’d have a lot meetings together, and talk about how we can boost product sales. I only started repping about fifteen months ago, so it’s a real novelty. My sales manager entered me, and it’s pulled through! So, it’s a real surprise, because I’m so new in this field.” Natalie Maginnis of IPN Communications, said, congratulating Sophie on taking home the award, “Pharmacy Reps are such an important part of any pharmaceutical company. If you don’t have good representation, then pharmacists and other healthcare professionals simply will not be aware of the quality of the products that you are offering! Hats off to Sophie, and all the other nominees for being a service to themselves and their employers.”

IPN Pharmacy Representative of the Year 2017 winner, Sophie Rickelton, Pharmacy Representative with Pamex Ltd with Mr Barry Maguire, Commercial Manager, IPN

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Awards The Irish Pharmacy

2017

HOSPITAL PROFESSIONAL NEWS IRELAND

HPN Respiratory Team of the Year Award 2017

Chemco Take Inaugural Respiratory Award - The winner of this year’s HPN Respiratory Team of the Year was Chemco Pharmacy, Bandon. On the 3rd February 2017, Chemco Pharmacy held a unique innovative ‘Asthma in the Pharmacy Day’ for their customers, involving the input of an Asthma Society Nurse as well as their Pharmacy team, to help make customers aware of asthma. The aim of the event was to improve customer’s understanding of their medicines, answer any questions they have and improve communication between the customer and their pharmacist. The structure of the Day consisted of two parts, the first was an ‘Asthma in the Pharmacy’ session and the second was a question and answer session with a store pharmacist. The day was organised in a way that would be particularly beneficial to customers, who were encouraged to bring along their inhalers. The Pharmacy team also set up ‘Asthma Stands’ in the style of information stations covering a range of pharmacy topics in store. Speaking to Irish Pharmacy News, Tomas Deasy from Chemco Pharmacy said, “it has been a fantastic experience and I am truly honoured to accept this Award on behalf of Chemco Pharmacy in Bandon. It was a truly great experience to try and give asthma awareness into the local customer base in Bandon. “I’d like to the IPN Awards for giving our team the opportunity to showcase what we can do as a team, to demonstrate to our customers what can be done at a local level, to give advice compassionately to all of our customers. I think that’s what this is all about, to raise awareness of asthma, and that’s what this really is, it’s a platform for us to show what we can do.” Congratulating Chemco Pharmacy on the Award, Editor of Hospital Professional News Kelly Jo Eastwood said, “Asthma awareness, and proper respiratory care are an incredibly important aspect of healthcare, particularly in the Pharmacy setting, as pharmacists are the first port of call for many patients with respiratory difficulties and issues. Congratulations to Chemco Pharmacy on such a well-planned, and effective information campaign.

HPN Respiratory Team of the Year Award winner, Tomas Deasy, Pharmacist, Chemco Pharmacy, Bandon with Mr Oliver Carroll, Chairman, Asthma Society of Ireland

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Awards The Irish Pharmacy

2017

iMed Community Pharmacy Technician of the Year 2017

Taking the role of Technicians Forward - The winner of this year’s iMed Community Pharmacy Technician of the Year was Aisling Devane, Ballisodare Pharmacy, Sligo. Aisling impressed the Irish Pharmacy Awards judges with her dedication to enhancing the role of community pharmacy technicians. Aisling’s diligence ensures her Pharmacy runs seamlessly from day-to-day, with pharmacists and staff left with time to perform other duties such as flu vaccinations, weight management clinics, smoking cessation clinics, cholesterol testing, BP testing, Midazolam training for care assistants, diabetes managements, skin assessments, and urine analysis. Often going the extra mile for customers, Aisling has dressed patient’s wounds, with her training as a nurse becoming an invaluable service in her community. Aisling also oversees all dosset pack patients and provides the same seamless approach via templates, and is noted for being particularly conscientious in explaining medications to patients. Recently Aisling has changed the way in which her Pharmacy files patient’s records, providing her staff with a clear sleeve, making it much easier for the pharmacist to get access to all the patient information in timely fashion. In addition to this, Aisling is involved in the procurement of medicines within the dispensary and always ensures High Tec medicines as well as unlicensed medicines are ordered in a timely fashion and the patient contacted once received by the Pharmacy. “I am definitely in shock, definitely didn’t expect to get it! It means a lot! It’s really nice to be recognised” she said, speaking to Irish Pharmacy News upon receiving the Award. Aisling also acknowledged the hard work done in Ballisodare Pharmacy, and noted the importance that community pharmacy has to patients’ lives. “We have a great team at Ballisodare Pharmacy. We deal with customers on a day-to-day basis with various medical problems, and we try to get our customers to leave with satisfaction, and also to make a little bit of a difference in a person’s life.”

Aisling Devane from Ballisodare Pharmacy, Sligo, winner of the iMed Community Pharmacy Technician of the Year 2017 Award pictured with Mr Pat Roche, County Manager, iMed International

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Mr Pat Roche, County Manager for Ireland with iMed International said, "iMed are delighted to be associated with this Award, recognising the hard work and dedication carried out by community Pharmacy Technicians across Ireland. The quality of shortlisted finalists is testament to that. Many congratulations to Aisling Devane on her accolade.”


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Abbreviated SPC Nolpacid 20 mg gastro-resistant tablets,contains 20 mg of pantoprazole as pantoprazole sodium sesquihydrate. Indicated for short-term treatment of reflux symptoms (e.g. heartburn, acid regurgitation) in adults. No dose adjustment is necessary in elderly patients or in those with impaired renal or liver function. Nolpacid is not recommended for use in children and adolescents below 18 years of age due to insufficient data on safety and efficacy. Precautions: Nolpacid 20 mg gastro-resistant tablets should not be chewed or crushed, and should be swallowed whole with liquid before a meal. Patients with long-term recurrent symptoms of indigestion or heartburn should see their doctor at regular intervals. Especially, patients over 55 years taking any non-prescription indigestion or heartburn remedy on a daily basis should inform their pharmacist or doctor. Patients should not take another proton pump inhibitor or H2 antagonist concomitantly. Patients should consult their doctor before taking this medicinal product if they are due to have an endoscopy or urea breath test. Patients should be advised that the tablets are not intended to provide immediate relief. Patients may start to experience symptomatic relief after approximately one day of treatment with pantoprazole, but it might be necessary to take it for 7 days to achieve complete heartburn control. Patients should not take pantoprazole as a preventive medicinal product. Contraindications: Hypersensitivity to the active substance or to any of the excipients listed in section 6.1. Co-administration with atazanavir (see section 4.5). Adverse reactions: Sleep disorders, headache, dizziness, diarrhoea, nausea / vomiting, abdominal distension and bloating, constipation, dry mouth, abdominal pain and discomfort, liver enzymes increased (transaminases,-GT), rash / exanthema / eruption, pruritus, asthenia, fatigue and malaise, agranulocytosis, hypersensitivity, hyperlipidaemias and lipid increases, weight changes, depression, taste disorders, disturbances in vision / blurred vision, bilirubin increased, urticaria, angioedema, arthralgia, myalgia, gynaecomastia, body temperature increased, oedema peripheral, thrombocytopenia, leucopenia, pancytopenia, disorientation, hyponatraemia, hypomagnesaemia, hallucination, confusion, hepatocellular injury, jaundice, hepatocellular failure, Stevens-Johnson syndrome, Lyell syndrome, erythema multiforme, photosensitivity, subacute cutaneous lupus erythematosus (see section 4.4), interstitial nephritis. Shelf Life: 5 Years. Legal Category: Medicinal product not subject to medical prescription. Marketing Authorisation Number: PA1347/032/001. Marketing Authorisation Holder: Krka, d. d., Novo Mesto, Šmarjeska cesta 6, 8501 Novo mesto, Slovenia. SPC: http://www.hpra.ie/homepage/medicines/medicines-information/find-a-medicine/results/item?pano=PA1347/032/001&t=NOLPACID Date of Preparation: 26/04/2017. Additional information is available on request from KRKA Pharma Dublin Ltd. Unit 4A, Leopardstown Business Centre, Ballyogan Road, Leopardstown, Dublin 18. D18 KX88– Tel: 01 293 9180. Reference number: 01-06-2017.


Awards The Irish Pharmacy

2017

KRKA Counter Assistant of the Year 2017

Rhonda Finnegan Counters the Competition - The winner of this year’s KRKA Counter Assistant of the Year Award was Rhonda Finnegan, of McCartan's Pharmacy Sutton. Rhonda is noted for the hard work she puts in her job each day, as well as her involvement in attending and helping organise in-house training across the group, ensuring that reps and trainers are directed to the best point of contact across each shop. Rhonda also works closely with the supervising pharmacist to ensure that Standard Operating Procedures training is individualised to ensure the smooth workflow of the pharmacy. “It's nice to be recognised for what you do,” Rhonda said, speaking to Irish Pharmacy News on the night of the awards. Rhonda was quick point out that in addition to the importance of the expertise of pharmacists, an informed, alert, and impassioned floor-team are paramount to the successful running of a Pharmacy. “While we take the lead from the pharmacist, the girls on the floor absolutely do have to be at their best, and working hand-in-hand with the pharmacist is crucial. Otherwise, the business wouldn’t survive. “I’ve been doing it so long that I don’t see any difference in what I do from day to day trying to move the business forward, trying to help staff on their way, trying to trying to be a colleague and a friend, and I think a lot of girls, and guys in business become very close-knit.” Congratulating Rhonda on her Award, Mr Daniel Byers, KRKA Country Manager for Ireland said, “Counter Assistants are very often the first line of support that a patient receives when looking for help and information. “It was KRKA’s pleasure to support an award that at its core rewards those who consistently provide exceptional customer service, professionalism and dedication. Congratulations to Rhonda on their fantastic achievement.” KRKA Counter Assistant of the Year 2017 winner Rhonda Finnegan, McCartans Pharmacy, Sutton Cross with Mr Daniel Byers, Country Manager, KRKA Ireland

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Awards The Irish Pharmacy

2017

Irish Medical Times Excellence in Diabetes Management Award 2017

Paul Displays Expertise in Diabetes Management - Cunningham’s Pharmacy took away this year’s Irish Medical Times Excellence in Diabetes Management Award, with Pharmacist Paul Cunningham, himself a person with diabetes type 1, going above and beyond to provide the best care for his customers. His own status as a diabetes type 1 patient informs the attentiveness, and attention to detail he provides in his care, and he stocks a number of technologies and gadgets designed to help diabetic patients. His Pharmacy also has a text and collect system, minimizing the workload in the dispensary, and allowing customers to collect medicines in a more convenient fashion. They also stock ‘as many replacement glucometers as we can get our hands on’, and try to always have diabetes diaries in stock for customers. In addition to this, a number of years ago, Cunnigham took the initiative to install ipads on his stores tils, so that customers would access to health-related apps. Upon receiving the Award, Paul said, speaking to IPN ,“I take it for granted, the work that we do. But when I think about it, I do realise that we have an impact on people’s lives every day. I don’t think we fully realise the effect, as a profession, that we have on people’s lives. Congratulating Paul on winning the Award, Helen Martin, Publisher of the Irish Medical Times said, “Paul Cunningham of Cunningham’s Pharmacy in Athlone brought a very personal touch to winning this year’s ‘Excellence in Diabetes Management’ Award, given that he has lived with type 1 diabetes himself for more than 20 years. “With chronic disease forecast to affect up to 40% of Irish adults by 2020 – and with diabetes being one of the so-called ‘big six’ – we need to be doing more to educate the public on both type 1 and especially type 2 diabetes. As a publisher, this is something we also strive to provide for our medical readers. “MPI Media – publishers of Irish Medical Times and MIMS Ireland – is delighted to sponsor this winning Pharmacy, which has gone that extra mile in order to given its customers the time, knowledge and practical advice to control their condition.”

Irish Medical Times Excellence in Diabetes Management Award 2017 winner, Paul Cunningham, Pharmacist, Cunninghams Pharmacy, Athlone with Irish Medical Times Publisher Helen Martin

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Awards The Irish Pharmacy

2017

United Drug Business Development (Independent) Award 2017

Eamonn Evolves his Pharmacy - The winner of this year’s United Drug Business Development (Independent) Award was Eamonn Brady, of Whelehan’s Pharmacy. The winner of this year’s United Drug Business Development (Independent) Award was Whelehan’s Pharmacy, Mullingar. Whelehans owner, Eamonn Brady and his team wanted to grow the number of in store services available in their community. After opening a new facility, service offerings such as heart screening, cholesterol testing, food intolerance tests and glucose tests were all increased, and made available to the public. Whelehans also offer several ‘in house’ services in their centre, including physiotherapy, chiropody, and nutrition, meaning even more convenience for customers and patients. Having tried and tested the services within the store in an ad hoc way to assess viability, and based on the growing demand, Eamon and his team had full confidence that there would be huge interest from the public. Speaking to Irish Pharmacy News, Eamon said, “On behalf of the team at Whelehan’s Pharmacy, we are delighted to have won the United Drug Business Development (Independent) Award. Our Pharmacy in Mullingar was established in 1898, under a very traditional Pharmacy model at that time.” When asked about his success, Eamonn explained that he wanted to offer more than just the traditional to his community. “We wanted to bring something else to Mullingar and the surrounding area, so we developed from the traditional dispensing model, bringing in other healthcare professionals, so we have chiropodists, and physiotherapists, and we have an asthma clinic. “Also, we’ve tried to develop from the medical side. We have a beautician instore, and it really compliments our business model. It brings people in, and it also gives us the opportunity to engage with them. It’s worked well from a business perspective, and I have a great team behind me.”

United Drug Business Development (Independent) Award winner, Eamonn Brady, Pharmacist, Whelehan’s Pharmacy Mullingar with Mr Stephen O'Donoghue, United Drug Wholesale Commercial Director

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Stephen O’Donoghue, Director at United Drug, said, “At United Drug, we work shoulder-to-shoulder with independent pharmacists across Ireland, all of whom provide a vital service to their local communities. Our industry is constantly changing and evolving; the only thing that remains consistent is the need to provide patients with the very best healthcare solutions that meet their ever-changing needs. We would like to congratulate Eamonn Brady and his team at Whelehan’s Pharmacy for this much-deserved award win. We look forward to continuing working with Eamonn and the wider independent Pharmacy community in delivering excellent services to Irish patients across Ireland.”


Awards The Irish Pharmacy

2017

RB Nurofen for Children Baby Health Pharmacy of the Year 2017

Sheena does the Double for Baby Care - The winner of this year’s RB Nurofen for Children Baby Health Pharmacy of the Year Award was Milltown totalhealth Pharmacy.

Winner of the RB Nurofen for Children Baby Health Pharmacy of the Year Sheena Mitchell, Milltown totalhealth Pharmacy with Mr Adrian McCourt, Senior National Account Manager, RB Ireland

Expanding on their success from last year, the Pharmacy’s WonderBaba blog has continued to have a huge impact on their presence within the local and national baby market. Their online shop www. milltownpharmacy.ie has continued to grow, and approximately 95% of their orders are related to the baby and child market. The blog also receives 10,000 hits per month, and engages with a community of 11,000 Facebook followers.

Pharmacist Sheena Mitchell has answered thousands of one-to-one queries which takes dedication and commitment of an extraordinary level. She also sits on the “mummypages” panel as their expert Pharmacist and has recorded several baby information videos with them for “mummypages” Speaking to Irish Pharmacy News upon receiving the Award, Sheena said, “We’re here defending our title this year. We won this Award last year, so we’re even more excited to be

here. The moment you walk in, the standard is so high, it has a really sophisticated tone to it, so we’re really excited to be here enjoying the atmosphere. “We’re really driven to provide the best baby Pharmacy service that we can. We focus particularly on the online market. We address patients concerns from basically everywhere in Ireland through our Wonderbaba blog, and we like to think that we provide a seamless level of care straight through to deliver of product to the door.”

Congratulating Sheena on her second consecutive victory, Mr Adrian McCourt, Senior National Account Manager with RB Ireland said, “RB is delighted to again sponsor this Award and support all of those in the pharmacy community who are committed to helping new parents and young families. “On behalf of the entire RB team, we would like to take this opportunity to congratulate both this year’s winner Sheena Mitchell, and all of the finalists.”

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Awards The Irish Pharmacy

2017

Cellnutrition Business Development (Chain) Award 2017

Cellnutrition Business Development (Chain) Award - The winner of the Cellnutrition Business Development (Chain) Award was Allcare Pharmacies.

Cellnutrition Business Development (Chain) Award 2017 went to Allcare Pharmacy Group. Pictured is Nicola Abbott, CEO, Cellnutrition with Allcare Pharmacy's Sarah Leadbetter, Aisling Cahill and Sarah Sambrooks The chain took away the award after it’s wellness campaign particularly impressed the Irish Pharmacy Awards Expert Judging Panel.

a four-month pilot from September to December 2016, sales in Wellness/VMS grew by 34.1% on average in three trial stores while the group grew by 6.3%

In September 2016, ‘wellness at Allcare’ was launched in three Allcare stores. The locations that were chosen for the trial were unique in the fact that each had a totally different demographic, age profile, level of disposable income and level of education. The objectives were to increase sales/ margin, identifying new products, as well as training their pharmacy teams to deliver the above

Sam Sambrooks from Allcare Pharmacies, who accepted the award, said, speaking to Irish Pharmacy News, “We’re very proud to have won this award, and to have developed this project last year in and around wellness, and to have implemented it in 12 stores. We’re going have further roll out across the Allcare Pharmacy Group around Ireland.”

The trial was a success, and over

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Ms Sambrooks also took the opportunity to acknowledge the

hard work done by the team at Allcare, and noted success of the initiative, for both customers and Allcare. “The initiative was to implement a new strategy around the decline in VMS catagrory in our pharmacies, and to provide a new shopping experience for our customers, to find exciting new ranges, and also for us as a pharmacy group to make a margin out of it,” she said. “I’d like to acknowledge the members of our team, who helped to engage customers in the experience of our new wellness strategy in our pharmacies.”

Congratulating Allcare on the Award, Cellnutrition CEO Nicola Abbott said, "Cellnutrition is proud to sponsor an Award which acknowledges business acumen and development within pharmacies. The world of business can be challenging at times so it is brilliant to be able to reward those who are excelling in their field. Huge Congratulations to the winners Allcare Pharmacies. “The award has a special place in Cellnutrition's heart as we initially established ourselves in pharmacies within Ireland and are excited to cements existing and create new relationships across the country.”


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Awards The Irish Pharmacy

2017

QuintilesIMS Superintendent Pharmacist of the Year 2017

Eugene is the Super for Meaghers - The winner of this year’s QuintilesIMS Superintendent Pharmacist of the Year was Eugene Renehan, of Meagher’s Pharmacy Group. Dedicated to the betterment of Pharmacy as a profession, on October 2015 Eugene set about developing the Meagher’s health strategy for 2016 as part of their company strategy. On top of this, Eugene set about developing and updating a suite of patient information leaflets to educate patients, which are now available in each of the Meaghers stores, covering areas such as high blood pressure, asthma and iron checks. Eugene identified a patient need, which was simpler, more direct patient information leaflets. Previously, they had been difficult for patients to understand. Eugene used his years of patient consultation experience and feedback from customers and colleagues to provide this update. Eugene also spearheaded Meagher’s Flu Vaccination campaign, co-ordinating training of pharmacists, and the distribution of said information to the public through various social media channels. In addition to this, Eugene encouraged all 15 of Meagher’s pharmacists to engage in or update their vaccination and CPR training. He then ran a training session for the younger pharmacists to further improve their consultation skills, ensuring they were comfortable and clear with how to carry out the consultation according to their SOPs which were based on best practices and PSI Guidance. Speaking to Irish Pharmacy News upon receiving the Award, Eugene said, “It’s really important to get recognition for community Pharmacy in Ireland, and it’s important that nights like this have recognition for the work that is done in community Pharmacy. I work with a great team in Meagher’s Pharmacy, I have a great mentor in Oonagh O'Hagan, and a great team of pharmacists who work tirelessness every day to help the community. Mr Feargal O’Shea, Pharmacy Key Account Manager with QuintilesIMS added, "IMS Health is the world’s leading information, services and technology company dedicated to working alongside our clients to enhance healthcare provision. We are currently working in partnership with 30,000 pharmacies across Ireland and Europe to improve business performance and we are committed to providing innovative and valuable new offerings to enhance services to patients and to improve your pharmacy’s commercial performance. "At QuintilesIMS Health we are delighted to once again sponsor the Superintendent Pharmacist of the Year Award. Superintendent pharmacists have an enormously demanding role, carrying full-time responsibility and accountability for pharmacies and continue to be at the forefront of innovation and progression in Irish pharmacy. We understand the hard work and dedication required by Superintendent pharmacists and the exceptional commitment to patient care necessary to meet the needs of all patients within your communities. The Irish Pharmacy Awards is a fantastic way to recognise and showcase this work and to celebrate your hard earned success. QuintilesIMS Superintendent Pharmacist of the Year 2017 Award went to Eugene Renehan, Superintendent Pharmacist, Meaghers Pharmacy Group (right) with Mr Fergal O’Shea, Pharmacy Key Account Manager, QuintilesIMS

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"We would like to congratulate all the finalists and give say a huge well done to Eugene on winning the Award.”


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Awards The Irish Pharmacy

2017

McLernon Computers Innovation & Service Development (Independent) Award 2017

Burren Brings Innovation to the Fore - The winner of this year’s McLernon’s Innovation & Service Development (Iindependent) Award was The Burren Pharmacy in Lisdoonvarna. and that’s the reason that we have developed so many new services and innovations and we’re thrilled that we’re being recognised here tonight. “Every day, through conversations with our patients, we come across situations whereby we can vastly improve healthcare outcomes by implementing simple innovations. So our simple innovations would have been leaflets in hand, giving advice that patients might not have been aware of for certain procedures, and then onto purchases of screenings.” Mr Robin Hanna, Director with McLernon Computers said, “Everyone at McLernons is delighted to congratulate Michelle and the team from Burren Pharmacy on their success on winning the ‘Innovation and Service Development’ Award for an Independent Community Pharmacy.

McLernon Computers Innovation & Service Developement (Independent) Award winner 2017, Michelle Quinn, Pharmacist, The Burren Pharmacy, Lisdoonvarna with Mr Robin Hanna, Director, McLernon Computers

Every year the Burren Pharmacy is noted for its engagement with the local community through a series of events and initiatives. This year, among a number of initiatives, the Pharmacy participated in operation transformation, with walks being scheduled from the pharmacy twice a week with pharmacist led weigh-ins and blood pressure testing. Further community involvement icluded lead sponsorship of 'Strictly Come Dancing –

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Lisdoonvarna' which raised approximately ¤20,000 towards the development of community sporting facilities. The Pharmacy also became involved in a campaign to fund the long-term care needs of a boy in the community suffering from cystic fibrosis. Michelle was instrumental in engaging with her suppliers, and the community, ultimately made a generous contribution to the campaign.

Michelle has directed significant efforts over the last year into improving counter staff procedures through training, and helped to organise awareness days for members of the community, public outreach campaigns, skin clinics and days for expecting mothers, promoting Pharmacy in her community. Upon receiving the Award, Michelle noted that “it means so much to us, every day we strive to improve patient care,

“McLernons have been associated with the Irish Pharmacy Awards since their inception, realising the important function they perform in celebrating excellence in the profession and highlighting the exemplary instances of dedication, enthusiasm and unique set of skills which pharmacists bring to their communities. We support our Pharmacy customers not just through sponsorship of this award, but also with our dedicated teams of trainers, engineers and customer services members who go above and beyond to provide the services that our customers need.”


Awards The Irish Pharmacy

2017

GSK Self-Care Award 2017

Amy Awarded Self Care Title - The winner of this year’s GSK Self Care Award was Kieran’s Avenue Pharmacy. Amy Kieran reached a wider audience through her use of social media, using Facebook and Snapchat to reach customers and patients, empowering them to care for themselves - they are able to watch her videos from the comfort of their own home. In her social media posts, Amy addresses health issues in these such a psoriasis, how to identify it, how to treat it and keep it at bay. These videos also incentivise customers to then visit the store for more information and help. Kieran also created an online store for customers who prefer to do their shopping on the internet, as well as a prescription collection service from the GP, and a delivery service, making a huge difference to the lives of people Amy has registered the pharmacy for e-prescribing so that they can receive electronic prescription from prescribers. This is going to be the future for Pharmacy & will help to minimise time spent reading handwriting, reduce risk of error and potential forgery. Accepting the Award on behalf of Kieran’s Pharmacy, Linda Nevin said, “It’s really good to win the GSK award on behalf on Kieran's Avenue Pharmacy, Dundalk. This is the second time we have won at the Irish Pharmacy Awards over the last two years so we really are truly delighted and proud.” Nevin also noted the important role innovation plays for community Pharmacy in serving their patient populations. “I think we’re progressing, we’re a Pharmacy with a difference, and we’re bringing a lot of new things to Pharmacy, workshops, tea days for the elderly, workshops for children, and a lot of things like that.” Mr Matthew Beattie, Pharmacy Customer Business Manager with GSK Consumer Health said, “GSK is delighted to sponsor the Self Care Award which recognises the critical role pharmacists play in our community and the unique engagement pharmacists have with their patients and customers. “The Award is closely aligned with GSK’s focus on training, and our commitment to adding value through education and other value adding services. Congratulations to Kieran's Avenue Pharmacy.”

GSK Self Care Award 2017 Award was won by Kieran's Avenue Pharmacy, Dundalk. Pictured is Counter Assistant Linda Nevin with Mr Matthew Beattie, Pharmacy Customer Business Manager GSK Consumer Health

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Awards The Irish Pharmacy

2017

Unilever OTC Retailer of the Year Award 2017

Big Boots for OTC Retailer of the Year - The winner of this year’s Unilever OTC Retailer of the Year Award was Boots Ireland. The team at Boots are involved in helping to organise training days, promotion activates, as well advice and information to customers, and their reputation among their customers reflects the hard work that they put in each day. Over the last nine months, to acquire a better understanding of their customers, Boots have undertaken team key pieces of customer research, with customers telling staff that would like to see information regarding the best direction for them to take their healthcare. This empowered pharmacists, OTC staff, as well as, most importantly, the customers themselves. The results were also immediate in terms of sales uplift as customers could better navigate the fixture from in front of the counter. In addition to this, Boots supports it’s colleagues via a Healthcare Advisors Conference with comprehensive training on selected topics, is supported and delivered by their suppliers. IPN caught up with Anne Marie Brett, Senior Buying Manager ROI Healthcare at Boots and her team following their win as Unilever OTC Retailer Award 2017 . “It’s been great to win the Unilever OTC Retailer of the Year Award. As a team in Boots we’re always focused on the customer – we use a lot of insight to understand what our customers are looking for. And we use that every day to try and come up with the right plans, to engage customers and colleagues in stores. We’ve also worked really hard on the training side of things, ensuring that our colleagues are set up to have great conversations with customers, no matter what conditions they present with.” Unilever was the sponsor of the OTC Retailer of the Year Award 2017 and Colm Dowling, Customer

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Unilever OTC Retailer of the Year 2017 Award winner was Boots Ireland. Pictured are Caoimh McAuley, Bernadette Lavery, Boots Ireland, Mr Colm Dowling, Pharmacy Customer Accounts Manager, Unilever, Ann Marie Brett, and Kerry Murray, Boots Ireland Account Manager presented the Award.. “Unilever is delighted to present this Award to Boots Pharmacy group,” he said. “They are a remarkable Pharmacy group who have clearly demonstrated how important the OTC side of

community pharmacy is as part of the front line of healthcare provision. “This is the third year Unilever has presented this award at the Irish Pharmacy Awards and it is great to see the high calibre of entrants each year.

“Unilever would like to extend its congratulations to Boots for all their hard work and dedication to their customers that they continuously display year on year. This reflects something Unilever is passionate about – enhancing the lives of people in our local communities.”


Awards The Irish Pharmacy

2017

Uniphar LinkUP Young Community Pharmacist of the Year 2017

Sarah Chambers – A Hero for Pharmacy - The winner of this year’s Uniphar LinkUP Young Pharmacist of the Year Award was Sarah Chambers, of Hickey’s, Grafton Street.

Mr Dermot Ryan, Managing Director, Uniphar Retail Services presents the Young Pharmacist Award to Sarah Chambers, Hickey's Pharmacy, Dublin Sarah is known to have been a driving force in terms of the advancement of clinical services in Grafton Street Services, such as the ‘Let’s get Checked’ STI screen, an ambulatory BP monitoring, cholesterol and diabetes screening and advanced vaccination services. All of these services are readily available to the public. Sarah also organised a number clinics for such services, making them easily available to people working in the city centre Monday to Friday who may not otherwise be able to avail of them. Probably one of the most important examples is seasonal flu vaccination.

The Grafton Street branch has seen year on year growth in the uptake of this service because of the links that Sarah has made with the client base in the surrounding areas. Sarah also conducts regular extensive training in store with all staff members on dealing with emergency medical situations. She has also developed innovative ‘emergency boxes’ for adults and children which contain lifesaving adrenaline, CPR mask, and timers. These emergency boxes have been an important tool in recent months when Sarah has had to deal with a number of emergency situations in the Grafton Street store. Her organisation, training and staff

training, and her innovative emergency boxes have meant that these emergencies were dealt with effectively, safely and calmly, ending in optimum patient outcomes. Speaking to Irish Pharmacy News on the night of the Awards, Sarah said, “It’s such a shock and a privilege even to be nominated. It’s a team effort, so it really is the help that I get on a day-to-day basis from Yvonne and Richard in the store, and from Hickey’s in general.” Dermot Ryan, Managing Director or Uniphar Retail Services added, “On behalf of Uniphar LinkUP, I’m delighted to congratulate

Sarah Chambers, winner of the Uniphar LinkUP Young Pharmacist of the Year 2017. We are happy to sponsor a category that recognises the contribution that young pharmacists are making to their profession and to their communities. Young pharmacists today are operating in a challenging environment where more is demanded of them clinically, commercially and from a regulatory perspective. Uniphar is committed to supporting community Pharmacy across Ireland and it is great to see young talent already rising to those challenges while putting their patients at the heart of everything they do. We wish Sarah all the very best in her career.”

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Awards The Irish Pharmacy

A.Menarini

Consumer Health

2017

The People’s Pharmacist 2017 in association with A.Menarini Consumer Health

Kilian is the People’s Choice - The winner of the People’s Pharmacist Award for 2017, in

association with A. Menarini Consumer Health, was Kilian McGreal of McGreal’s Pharmacy. Kilian often goes above and beyond the call of duty for patients, and is known in his community for the high standard of care he provides. There were four other very worthy finalists in this particular category – Jason Doherty (Haven Pharmacy Rush), Michael Foley (Foleys Dublin), Lisa Malone (Castletown pharmacy, Celbridge), Niall Morison, (Morrison’s Pharmacy, Tipperary) and Martin Kantcheva, (Hilton pharmacy Dublin), all of whom received votes from patients and customers alike, praising the service they provide to their respective communities. “It’s an absolute honour to have won the People’s Pharmacist Award. I would like to thank A. Menarini Consumer Health for sponsoring it,” he said on the night, speaking to Irish Pharmacy News. This is the only category within the Irish Pharmacy Awards which has been nominated for, and voted on by, the general public. There was been an overwhelming response with over 9000 votes on social media. “I feel that this is being accepted on behalf of the local communities which we serve – without those communities, there’s no such thing as community pharmacy – and on behalf of the teams at McGreal’s Pharmacies. They’re absolutely exceptional at everything they do,” Killian added. Kilian was also quick to acknowledge the work done by pharmacists in his family in the past half-century, and discussed plans to expand his business even further in the future, providing an even better standard of care for his community. “I’m a third-generation pharmacist, and over fifty years of hard work has been put in to create that sense of community that we now have,” he added. “Over the next number of years we intend to further integrate our services: we just finished building primary care centers in Blessington, medical centers in Monasterevin…we want the pharmacist to be the integrated patient care specialist.” Congratulating Kilian, Johnny Murphy, Head of Consumer Health, of A. Menarini Consumer Health, said, “A. Menarini Consumer Health are delighted to sponsor the People's Pharmacist Award at the Irish Pharmacy Awards 2017. Community Pharmacists are often the first person who people seek out for advice on their health and well-being. A.Menarini Consumer Health like to congratulate all those nominated for this year's Award and to the winner, Kilian McGreal, of McGreal's Pharmacy, Blessington.” Johnny Murphy, Head of Consumer Health, A.Menarini Consumer Health and Kilian McGreal, McGreal's Pharmacy

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Awards The Irish Pharmacy

2017

Idis Community Pharmacist of the Year 2017

Total Support for Nial as Pharmacist of the Year - Pharmacist Nial Tully took away this year’s IDIS Community Pharmacist of the Year Award, for his outstanding work in the community. Nial is renowned for going the extra mile for patients and customers, often staying open past closing hours waiting patiently for a customer who had been delayed for whatever reason. He has also provided professional development services to nurses in local nursing homes, given health information talks to local community groups and national schools, and delivered health promotion and screening services related to diabetes, hypertension and cholesterol monitoring. In addition to this, Nial provides financial support to local clubs in his community, and has done much to raise awareness for the often overlooked field of Men's Health. He has built strong, working relationships with other healthcare professionals in the locality, which serves only to add to the standard of healthcare being provided in Castlerea. Speaking to Irish Pharmacy News upon receiving the Award, Niall said, “it’s great to win the Award, and I’m very grateful for it. I’m very happy and grateful to the team in totalhealth Pharmacy who have helped me to come out into the community. “It’s very important to be out in the community, and to get that trust in local care that we can all provide,” he added. Congratulating Nial on the win, Anna Ryan, Idis GA and Clingen Group Key Account Manager for Ireland said, “Idis Global Access are honoured to sponsor an Award that recognises the invaluable contribution of the community pharmacist. This Award recognises their dedication and commitment to meeting the individual needs of the patients in their community. “This award links perfectly with the vision & mission of Idis Global Access, to source a world of medicines to reflect the individual patient needs. Just as we provide a go to solution for pharmacists to assist them in accessing medicines for their patients, these pharmacists are the "go to" solution for their patients.”

Idis Community Pharmacist of the Year 2017 winner Nial Tully - Tully’s totalhealth Pharmacy, Castlerea with Anna Ryan, IDIS GA and Clinigen Group Key Account Manager for Ireland

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Awards The Irish Pharmacy

2017

Johnson & Johnson Community Pharmacy Team of the Year 2017

Meaghers Team Take Second Accolade - The winner of this year’s Johnson & Johnson Community Pharmacy Team of the Year Award was Meagher’s Pharmacy, Barrow Street.

Johnson and Johnson Community Pharmacy Team of the Year 2017 - Meaghers Pharmacy, Barrow Street Dublin. From left to right: Leanne Fallon, Kate Clarke, Lisa Coffey, Meaghers Pharmacy, Mr Brendan McLoughlin, Pharmacy Channel Manager, Johnson and Johnson Ireland, Trish Cahill, Nicole Fallon, Neil Boles and Elaine Southern, Meaghers Pharmacy This year, there were eight nominees for the award, with teams from Adrian Dunne (Baldoyle), Hickey’s (Fortunestown), LloydsPharmacy (Ringsend), O’Regan’s Pharmacy (Tallaght), Stacks (Bettystown), Sam McCauley’s (Tralee), and The Maple Pharmacy (Dublin) all demonstrating teamwork, dedication, and efficiency in their entries. The Barrow Street team say that they demonstrate their core values in everything they do, allowing them to work together effectively through collaboration.

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The team members respect and value each other’s opinion and trust each other. When faced with any challenge, task or obstacle the team work together as a single unit to decide on how best to approach the task.

being positive that the challenge could be overcome. The team also took part in a brainstorming session regarding how to get the job done as quickly, and efficiently as possible, ultimately resulting in success.

Recently, the team faced a tough challenge in taking on their end of year stocktakes. The team were faced with rectifying stock levels, stock taking the entire store in a very short period of time, completing it in just three days.

Speaking to Irish Pharmacy News following the win, Kate Clarke, Managing Supervising Pharmacist in Barrow Street said, “it’s great to be nominated against such other great teams, so it’s wonderful to win and we’re very honoured.”

They embraced the challenge, with each of them participating, and

“Our team works really well together, and we’re just very

supportive to each other,” she added. “And also our wider Meagher’s team. One of our core values is family, and we live by that every day.” Mr Brendan McLoughlin, Pharmacy Channel Manager with Johnson & Johnson said, “Johnson & Johnson is delighted to sponsor an Award that recognises the value of a team working collaboratively through anticipating the needs of customers both for now and for future requirements. Many congratulations to the Meagher’s Pharmacy, Barrow Street for winning this accolade in 2017.”


Summer Beauty

Hair Care Irish men and women are willing to spend on products to address specific hair and scalp concerns - whether that be colour, condition, or appearance. While some consumers buy these products at salons or department stores, many prefer the moreaffordable options that are as close as the pharmacy. While serious conditions should be diagnosed and treated, many aesthetic issues, minor-damage issues, and dandruff/scalp problems can be remedied by OTC products. The local pharmacy is usually the first port of call when it comes to dry or itchy scalp complaints, and for solutions for damaged or thinning hair. Customers will return to you if the products you’ve recommended have made a difference in the health of the scalp or the appearance of their hair.

Hot summer hair trends Bold hair on a budget - shoppers will want to re-create the latest rainbow hair, pastel tones, greys and denim (the new grey!), and will be looking for home colour kits to achieve this if they are on a budget. Offering some bold, experimental colours, alongside the usual selection of colours will help your customers stand out from the crowd. A selection of accessories, hairbands, clips and flowers will prove popular over the coming months.

Hair concerns Hair Loss - Hair loss can affect confidence and affect self-esteem in both men and women. Hair loss ranging from subtle thinning to alopecia is becoming more prevalent among women. Hereditary hair loss is the most common hair loss disorder affecting men and women – 40 per cent of men under the age of 35 are already losing their hair. Thinning of the hair in women or pattern baldness, is different from the pattern baldness seen in men. Women suffer from the problem usually after menopause though it can occur even in teenage years, due to stress, crash dieting, giving birth, bereavement, hormonal imbalance or an underlying illness, such as an underactive thyroid. Thinning of the hair or obvious hair loss usually starts thinning over the top and front of the head. Flaky scalp - Dandruff will affect around 50 per cent of adults at some point in their lives. The problem is commonly the result of a dry scalp and the yeast malassezia, which occurs naturally on the skin, can exacerbate the problem. Anti-dandruff shampoos and conditioners contain ingredients that either slow the production of skin cells, attack the fungus that can cause dandruff, or a combination of the two. It’s important differentiate between a dry scalp and dandruff, as the two scalp skin problems have common symptoms.

The market According to Euromonitor, the hair care market is worth ¤149 million. Growth remains relatively strong in hair care, especially considering the maturity of the category. New product development and innovation are helping to drive sales in the category. Procter & Gamble (Mfg) Ireland Ltd was the category leader in 2015 with a value share of 36%. While the company’s value share in the category is in decline, it still has some of the best-known brands in hair care, including Pantene and Head & Shoulders. Following the decision of the company to sell the majority of its beauty and personal care brands to Coty Inc in 2015, it is likely that the company will have more time to invest in its hair care brands in the future. Hair care sales are expected to rise to ¤155 million by 2020. The majority of hair categories are likely to continue experiencing positive value growth, with the main exceptions being 2-in-1 products and perms and relaxants. Sales in these categories and colourants and are expected to decline in volume terms as well as due to the trend of returning to hair salons to have professional colouring and styling treatments.

Top Hair products John Frieda offers a tailored solution to your customers’ needs when it comes to hair care – whether it be breakage prone, over-processed or dry and damaged. Taking a few moments to address each customer’s needs and offering a solution for a particular hair need means that your customers get an individual solution to help repair their distressed and damaged hair. For more information on the range please contact your Intrapharma Rep on 01-4632424

Bioxsine is scientifically tested for thinning hair in men and women, for male pattern baldness and for temporary hair loss in women. Clinical tests have proven that hair loss, hair growth and thicker hair result from regular use of Bioxsine Shampoos, Serum and Spray. The Bioxsine range contains the unique ingredient Biocomplex B11 which is clinically proven to help with hair loss and to stimulate hair growth. For more information on Bioxsine please contact Ocean Healthcare on 01-2968080.

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Summer Beauty

Skincare - Aging Skin Skin and cells age over time, but there are various vitamins and food supplements which can help not only to slow this process down but can also reverse the some of the aging effects, like reducing wrinkles and improving skin moisture levels. Skin changes as people age. Your customers may notice, and complain of wrinkles, age spots and dryness. The skin also becomes thinner and loses fat, making it less plump and smooth. It might take longer to heal also. Skin changes are related to environmental factors, genetic makeup, nutrition, and other factors, such as prolonged sun exposure and smoking which over time will reduce the skin's strength and elasticity.

What are customers looking for? Marie Therese Burke, Head Trainer with Graham Anthony Distribution, shared current skincare trends, her advice and best product picks with IPN. Products that do one job well are a key focus - Every year new skincare trends pop up as we try to find the best solutions to maintaining healthy and beautiful skin. “Do you want to know what the big skin care trends will be in 2017? Well look no further! One of the biggest skin care trends for the New Year will be focusing on localised treatments. This is basically a move away from global products e.g. a moisturiser or anti-ageing face cream to a localised product i.e. treating a deep wrinkle in isolation. Rather than using a product that looks to cover a range of problems we will use specific problem solvers for our skin. This will be done by treating a spot / breakout in isolation, targeting eye puffiness specifically where the problem is and not using that product all over the face, and finally using a specific cream for heavy legs rather than a general body cream that you can use on legs.”

Caring for the skin from within The basis for all basic healthcare is diet, and maintaining a balanced and nutritional diet is no exception to good skin care. However, as the body ages it is difficult to gain all of the necessary nutrients for skin to thrive. Foods containing high levels of Vitamin C, Vitamin B12, and Zinc should be sought out, while foods with high levels of sugar, or with a high glycaemic index should be avoided where possible. Not all of your customers may be aware of the difficultly in maintaining vitamin levels in the skin. Elderly people do not absorb nutrients as efficiently, and may need to keep their vitamin intake higher, to maintain the same levels as their younger peers. As vitamins are essential to your health and body functions, vitamin deficiencies can cause adverse effects on the skin. Since vitamins C and E play such important roles in protecting your skin from the sun, deficiencies in either vitamin can increase the risk of skin damage.

The market Sales in the skincare category total over ¤144 million. Consumer demand is increasing for skin that is youthful, radiant and hydrated. The category did remain relatively resilient to the economic downturn and as Ireland’s economy continues to improve and consumers have more disposable income and more confidence to spend, Irish consumers continue to invest in skin care products. According to Euromonitor, L'Oréal (UK) Ltd maintains the leading position within skin care with a value share of 17%. The company continues to produce some of the best-known and most trusted skin care brands in Ireland, including L'Oréal and Garnier in the mass segment and Vichy and La Roche-Posay in the premium segment. Skin care sales are set to rise to ¤156 million by 2020. Consumers did not stop investing in skin care during the economic downturn and many are likely to continue to have extra income to spend and this is set to continue to be the trend into the future. Growth is expected to be marginally slower due to declining average unit prices in some skin care categories. Imedeen® supplements are specially designed for different ages and skincare needs, taking beauty routines to a higher level. Signs of skin ageing begin on the inside long before they’re visible on the surface. Whether they are in their 30s, 40s, 50s or beyond, Imedeen skincare tablets work from within to help women look younger for longer by nourishing* the deep layer of skin untouched by traditional creams and lotions.*contains vitamin C which helps protect cells from oxidative stress and contributes to normal collagen formation for the normal function of skin. Revidox+ is a next generation anti-aging food supplement clinically proven to show visible results within 60 days. Revidox+ contains a vital mix of antioxidants, minerals and vitamins that work in harmony to address the signs of ageing and enhance the integrity of the skin. This includes: Pomegranate extract: rich in Ellagic Acid, polyphenols and Punicalagin, Vitamin C: a powerful antioxidant proven to promote healthy collagen formation (responsible for our skin’s elasticity) to help encourage firm, plump skin, Selenium: a vital mineral proven to shield cells from free radical damage whilst helping to maintain healthy hair and nails, Vitamin B2: assists with maintaining healthy skin and energy levels. Like Selenium it helps protect cells from oxidative stress, Zinc: supports healthy hair, skin and nails, as well as supporting natural immune function and STILVID® - a 100% bio-active and patented form of Resveratrol, an antioxidant derived from the skin of grapes. A growing body of evidence shows resveratrol’s health benefits in the entire body including the metabolism, cardiovascular system and cognition.

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THE MOST CONCENTRATED DERMATOLOGICAL BRAND. 100% TESTED ON SENSITIVE SKIN LAUNCHES IN IRELAND Developed in 1962 by visionary pharmacists Simone and Robert Veret, SVR was designed with one key aim “Beautiful Skin”. A true star in the field of dermo-cosmetics, SVR address all skincare issues and conditions including atopic skin, delicate and sensitive skin, oily and acne prone skin, pigmented skin, dry and rough skin, amongst others.

Prescribed by dermatologists in 45 countries

HigHest dosage of active ingredients witHout affecting skin tolerance

SVR LIFTIANE Anti-wrinkle and firmness solution that combats all signs of skin ageing with visible results after 7 days. 1 MINUTE TO LIFT. 1 WEEK TO FILL WRINKLES. CLINICALLY PROVEN.

Liftiane Crème Visibly fills wrinkles whilst firming the neck and face. Skin will be smoother and more luminous after one week. SVR Liftiane Crème RRP - €32.50

Liftiane Eyes + Lips Reduces winkles, dark circles and puffiness from the eye contour and lip areas. SVR Liftiane Eyes + Lips (Yeux + Levres) RRP - €26

Liftiane Crème Riche A delightful firming cream that fills wrinkles. Skin texture will be smoother and the complexion will be brighter after just one week of using this Rich Cream! SVR Liftiane Crème Riche RRP - €32.50

Liftiane Serum

A fresh illuminating serum that immediately lifts the skin and wrinkles while intensely redensifying for a “perfect skin” effect. SVR Liftiane Serum RRP - €36


Summer Beauty

Colour Cosmetics There are thousands of scientists and chemists working in the cosmetic industry, and the number of jobs continues to grow. Science and cosmetics have become inextricably linked in the minds of the consumer. Furthermore, it is an industry that continues to sell product even in uncertain economic times. Everyone wants to look good no matter how much money they’re making. Thus, with its mix of science and advice, the pharmacy is the perfect place to retail cosmetics. Pharmacies are already a rapidly growing market for driving sales of premium brands that consumers are happy to browse through and pick up in an uncluttered environment. Recently the global trend in the cosmetics industry is toward developing “medicinally” active cosmetics. Thus, the customer may have come in to seek advice on a specific skin condition such as acne, greasy or dry skin. Offering a good range for all skin types and budgets is key.

Who are your shoppers? Women aged 18 to 35 are the biggest spenders in today’s cosmetics market, and are more likely to be heavy buyers, meaning they purchase more than 10 types of products a year. The generation’s love for social media-driven trends of contouring and colour-correcting means that stocking a good range of range of concealers, primers, highlighting products, and sculpting kits for brows will entice these customers, who are willing to splurge to get the look right.

Summer 2017 trends Bold eyes and lips together is a key look for this summer and shimmer and sparkle on eyes lips and even ears (yes, ears!) were key looks at this year’s fashion week runways. Full, boyish brows are still on trend, brushed upwards to create thickness. It all about the 80’s this summer, so be sure to have a great range of neon and disco-inspired colour shadows on offer and of course, blue eyeliner. Bronzed, dewy skin is perfect for summer, and can be created with top brand highlighters or even Vaseline or coconut oil. The French manicure, is back, so a range of taupe and fawn shades will ensure your customers nails are on trend this season.

The market Colour cosmetics is a thriving market, worth over ¤110 million. While sales of colour cosmetics did not decline during the economic downturn, current value growth was stagnant during some years. The category is now benefitting from increasing disposable income levels as unit prices are stabilising or increasing in most colour cosmetics categories. According to Euromonitor, L’Oréal (UK) Ltd was the leading player in colour cosmetics in 2015 with a 17% value share, the result of a one percentage point increase over the course of the year. While L’Oréal Paris remains a company’s best-selling colour cosmetics brand overall in Ireland, the company’s positive growth is derived mainly from the rising popularity of the Urban Decay brand and the acquisition of the NYX brand, which was finalised in Ireland in 2015. Urban Decay is benefiting from the strong demand for its Naked eye shadow palettes, especially following the introduction of Urban Decay Naked Smokey in August 2015. The NYX brand has also become renowned for its contouring collection. Colour cosmetics sales are set to rise to ¤119 million by 2020. This is being driven by rising demand and higher volume sales, with average unit prices not anticipated to increase much further. Sarah Corr of Life Pharmacy offers some great tips to help customers in crisis with cluttered beauty bags “We’re oh-so-familiar with expiration dates when it comes to food, but when it comes to our face it’s a totally different story. Cosmetic products all have an expiration date but we all probably own that year-old mascara or makeup brush. If you can’t remember when you bought it, chances are it’s too old to be in your makeup bag”. Expired products can lead to eye and skin infections, so it’s a good idea to remind women to keep on top of their beauty bags and bin old items. The key to the success of your colour cosmetics category is a good range including popular natural and organic brands, from budget to high-end. Keeping up to date on the latest colours and offering advice, for example on foundations by skin type will keep customers returning to your pharmacy for the next “must-have” products.

Brand Focus Flique is Charlotte Crosby’s innovative luxury make up brand brought to you by Easilocks Cosmetics. From Charlotte herself; “I have been working tirelessly perfecting this superior product line! Gaining my experience in the industry for over 5 years and being a makeup fanatic myself, I’ve really grasped and understand the importance of product performance and high quality! My main goal for this completely Vegan friendly, animal cruelty free range was to create a premium, high end product at an affordable price" The range contains a mix of matte lipsticks, pallet’s, brushes and lashes which allow a play with colour ensuring your makeup is always on Flique! Joining forces with Easilocks Cosmetics, Flique is now ready to take the beauty industry by storm! Flique will be available in Irish Retail Pharmacy from June 2017!

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Feature Medication Adherence and Cardiovascular Disease Globally, the leading cause of death is due to a cardiovascular disease (CVD) Approximately 35 million people have an acute coronary or cerebrovascular event annually and almost half of these events occur in those with pre-existing CVD. Provision of essential drugs, improving provider-patient communication, and innovative tools like m-health can improve adherence to treatment in CVD patients, and pharmacists have an important role to play. The number of people with CVD worldwide is likely to exceed to 100 million soon, it is estimated. For this reason, it is important that healthcare professionals are equipped to provide the best care to patients in this growing group. Recommended for the management of patients with CVD or their risk factors includes medications such as: beta blockers, angiotensin-converting enzyme inhibitors, angiotensin receptor blockers (ARBs), statins and antiplatelet drugs. Below, Irish Pharmacy News looks at non-adherence in patients with cardiovascular disease, as well as some of the measures pharmacists can take to improve medication adherence in this regard. Non-adherence in heart patients Taking medication correctly may seem like a simple or personal matter, but non-adherence (or not taking medication as directed) is a complicated and common problem. People do not realize the real damage or consequences of non-adherence. Sometimes it can be fatal, or extremely detrimental to a patient’s health and wellbeing. When patients with chronic conditions such as cardiovascular disease do not take medication as directed, the repercussions can be severe. For instance, not keeping blood pressure in check can lead to heart disease, stroke, and kidney failure. In the United States, poor medication adherence takes the lives of 125,000 Americans annually, and costs the health

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care system nearly $300 billion a year in additional doctor visits, emergency department visits and hospitalisations. People may not take their medication because: • They may forget. • They may not be convinced of the medication’s effectiveness or be unsure that it is working. • They may fear the side effects or have difficulty taking the medication (especially with injections or inhalers). • And we all know that the rising cost of prescription medications is a barrier for many. Some may face a combination of these reasons for not taking their medications. One person may face different barriers at different times as he or she manages his or her condition. The Impact of Medication Adherence on Coronary Artery Disease Costs and Outcomes: A Systematic Review A 2016 study, titled ‘The Impact of Medication Adherence on

Coronary Artery Disease Costs and Outcomes: A Systematic Review’ found that while high medication adherence accounted for patients having better health, many studies did not account for the Healthy Adherer Effect. Given the huge burden of coronary artery disease and the effectiveness of medication therapy, understanding and quantifying known impacts of poor medication adherence for primary and secondary prevention is crucial. The authors of the report sought to systematically review the literature on this topic area with a focus on quantified cost and clinical outcomes related to adherence. Results It was found that 5 studies (4 of which focused on statins) that measured the impact of medication adherence on primary prevention of coronary artery disease and 20 articles that focused on the relationship between medication adherence to costs and outcomes related

to secondary prevention of coronary artery disease. Most of these latter studies focused on antihypertensive medications and aspirin. All controlled for confounding comorbidities and sociodemographic characteristics, but few controlled for likelihood of adherent patients to have healthier behaviours (“healthy adherer effect”). Healthy Adherer Effect Although the direction of the associations all point to significant coronary artery disease cost and outcome improvement with better adherence, only two studies found directly controlled for the healthy adherer effect (and one indirectly controlled for it by virtue of being a randomized trial), or the likelihood for patients who take their medications being healthier other aspects of their lives. Thus, there is a critical need for better studies with healthy user controls, especially as payers


Improved outcomes start here

Make it part of your ACS Treatment Plan

BRILIQUE® 60MG & 90MG FILM-COATED TABLETS (ticagrelor) PRESCRIBING INFORMATION. Consult Summary of Product Characteristics (SmPC) before prescribing. Use: Adults aged 18 years and older, co-administered with 75-150mg acetylsalicylic acid (ASA) daily unless specifically contraindicated: for the prevention of atherothrombotic events in patients with acute coronary syndromes (ACS); or a history of a myocardial infarction (MI) and a high risk of developing an atherothrombotic event. Presentation: 60mg or 90mg ticagrelor film-coated tablets. Dosage and administration: ACS: Treatment should be initiated with a single 180mg loading dose (two tablets of 90mg) and then continued at 90mg twice daily. Treatment with Brilique 90mg is recommended for 12 months in ACS patients unless discontinuation is clinically indicated. History of MI: 60mg twice daily for extended treatment in patients with a history of MI of at least one year and a high risk of an atherothrombotic event. Treatment may be started without interruption as continuation therapy after the initial one year treatment with Brilique 90mg or other adenosine diphosphate (ADP) receptor inhibitor therapy in ACS patients with high risk of an atherothrombotic event. Treatment can also be initiated up to 2 years from the MI, or within one year after stopping previous ADP receptor inhibitor treatment. Limited data on efficacy and safety of Brilique beyond 3 years of extended treatment. If a switch is needed, the first dose of Brilique should be administered 24 hours following the last dose of the other antiplatelet medication. Lapses in therapy should be avoided. For oral use. Brilique can also be crushed, mixed with water and either drunk or administered via a nasogastric tube. Contraindications: Hypersensitivity to the active substance or to any of the excipients. Active pathological bleeding. History of intracranial haemorrhage. Severe hepatic impairment. Co-administration with strong CYP3A4 inhibitors (e.g. ketoconazole). Precautions: Use with caution in patients at an increased risk for bleeding (e.g. recent trauma or surgery, coagulation disorders or recent gastrointestinal bleeding) or those on concomitant medication that may increase bleeding risk (e.g. NSAIDs, oral anticoagulants and/or fibrinolytics) within 24 hours of taking Brilique. Brilique should be stopped 7 days prior to elective surgery if the antiplatelet effect is not desired. In patients with a history of MI with prior ischemic stroke, treatment beyond 1 year is not recommended. Not recommended in patients on renal dialysis. Use with caution in patients with moderate hepatic impairment. Use with caution in patients with an increased risk of bradycardic events or when administered concomitantly with medicinal products known to induce bradycardia. Use with caution in patients with a history of asthma and/or COPD or a history of hyperuricaemia or gouty arthritis. Use in patients with uric acid nephropathy is discouraged. Creatinine levels may increase during treatment with Brilique, renal function should be checked according to routine medical practice and in ACS patients, one month after starting Brilique, paying special attention to patients ≥ 75 years, patients with moderate-

to-severe renal impairment and those receiving concomitant treatment with an ARB. Premature discontinuation with antiplatelet therapy including Brilique could result in an increased risk of CV death or MI due to the patient’s underlying disease and should therefore, be avoided. Co administration of Brilique is not recommended with a high maintenance dose of ASA (> 300mg) or with doses of simvastatin > 40mg. Co administration of ticagrelor with strong CYP3A inducers is discouraged, as this may lead to a decrease in exposure and efficacy of ticagrelor. No data are available on concomitant use of Brilique with other drugs that also are potent P-glycoprotein (P-gp) inhibitors and moderate CYP3A4 inhibitors (e.g. verapamil, quinidine) that may increase ticagrelor exposure. If the association cannot be avoided, their concomitant use should be made with caution. Caution is advised in co-administration with medicinal products that alter haemostasis or with SSRIs. Brilique is not recommended during pregnancy and breastfeeding. Patients who experience dizziness and confusion during treatment should be cautious when driving or using machines. Undesirable events: Very Common: blood disorder bleedings, hyperuricaemia, dyspnoea Common: gout/gouty arthritis, dizziness, syncope, headache, vertigo, hypotension, respiratory system bleedings, gastrointestinal haemorrhage, diarrhoea, nausea, dyspepsia, constipation, subcutaneous or dermal bleeding, rash, pruritus, urinary tract bleeding, blood creatinine increased, post procedural haemorrhage and traumatic bleedings. Uncommon: tumour bleedings, hypersensitivity including angioedema, confusion, intracranial haemorrhage, eye haemorrhage, ear haemorrhage, retroperitoneal haemorrhage, muscular bleedings and reproductive system bleedings. Consult SmPC for a full list of adverse events.Legal category: POM. Marketing authorisation number: 60mg – EU/1/10/655/011 and 90mg – EU/1/10/655/004. Further product information available on request from: Freephone 1800 800 899 or contact AstraZeneca UK Limited, Horizon Place, 600 Capability Green, Luton, Bedfordshire, LU1 3LU, United Kingdom. BRILIQUE is a trade mark of the AstraZeneca group of companies. Date of API preparation: 03/2016. Adverse events should be reported directly to: HPRA Pharmacovigilance, Earlsfort Terrace, Dublin 2. Tel: +353 1 6764971 Fax: +353 1 6762517 Website: www.hpra.ie e-mail: medsafety@hpra.ie. Adverse events should also be reported to AstraZeneca Medical Information on 1800 800 899. Approval ID: 969591.011. Date of preparation: May 2016.


Feature and purchasers are starting to apply large resources towards adherence improvement and thus need more precise estimates for return on investment analyses.

cardiovascular medications, such as lipid-lowering agents and ACEIs.

Improving medication adherence in the Pharmacy

The questionnaire was initially validated in a hypertensive population and found to be correlated with blood pressure control at 2 and 5 years.

A 2014 study, titled ‘The Pharmacist Role in Predicting and Improving Medication Adherence in Heart Failure Patients’, evaluated the effect of pharmacist involvement in the management of heart failure, and demonstrated improvements in medication adherence that dissipated once the intervention was withdrawn.

It has high sensitivity of 0.81 and low specificity of 0.44, meaning that if a patient is found to have high risk for nonadherence with the MMAS, that result is likely true.54 However, the tool still may miss some patients who are nonadherent. The 4-item yes/no questions about past medication use make it a quick and simple tool to use in practice.

Simply put: if a patient is not taking their meds, it is likely they are not looking after themselves in other parts of their lives, and pharmacists have a role to play in terms of ensuring that patients are living a healthy lifestyle.

While the 4-item version is the best validated and tested scale, an expanded 8-item scale has recently been developed and undergone limited validity testing in a hypertensive population. This newly expanded tool may be a future option after it is tested in more diverse populations, including those with HF.

Predicting non-adherence Many significant predictors of both medication adherence and nonadherence have been identified in heart failure patients. The Morisky Medication Adherence Scale and the Merck Adherence Estimator are simple and practical tools that may be useful for identifying nonadherence in heart failure patients. This is a short questionnaire that has been tested in patients with hypertension or diabetes and in those taking chronic

from the Hawthorne or observer effect. Because of the design of these studies, patients were likely aware that they were in the intervention group. Despite the fact that control patients were also periodically contacted to assess for endpoints, intervention patients experienced greater oversight from study personnel and therefore may have increased their compliance merely from participation in a clinical trial. Shorter trials, by design, may have less sensitivity in detecting differences in medication adherence because many patients refill their prescriptions 3 months at a time. Thus, longer trials allowing for more refill opportunities may be more sensitive in detecting changes in medication adherence. Adherence may have declined at the completion of the intervention, and in order to maintain improved adherence, the interventions must continue.

Pharmacist intervention studies

Other improvements caused by pharmacy intervention

Most pharmacist intervention studies with a medication adherence outcome demonstrated significant improvements when compared with a control group.

In addition to improvements in adherence, some pharmacy interventions were associated with improvements in exercise tolerance, forced vital capacity, quality of life, and decreased hospitalizations.

Two of the larger and more recent trials indicated that this effect on adherence lacked durability over time, possibly

In a meta-analysis of 12 randomized controlled trials assessing the impact of

pharmacist care activities in HF patients, pharmacist care was associated with a significant reduction in allcause hospitalizations and a nonsignificant reduction in mortality. Interestingly, interventions where the pharmacist participated as part of a multidisciplinary team (collaborative care) led to greater reductions in HF hospitalizations when compared with pharmacist-directed care. Another meta-analysis assessing comprehensive HF discharge planning and postdischarge support studies also demonstrated that most types of postdischarge support, including single home visits, home visits plus frequent telephone contact, and extended home care services, significantly reduced hospital readmissions Lifestyle Changes In addition to medication adherence, lifestyle changes have been shown to be extremely beneficial to patients in as quickly as six months. This could include: in increased physical activity, dietary modification/weight loss, and smoking cessation are of proven benefit and may improve outcomes in as quickly as 6 months. In addition to attempting to ensure that patients adhere to their medications, Pharmacists should also suggest these changes to a patient’s lifestyle.

News Benefits of BioActive magnesium shown in study It is a scientific fact that the mineral magnesium helps build and maintain strong and healthy bones. Actually, magnesium’s role in bone health was recently confirmed in a new study conducted by scientists from the University of Bristol in the United Kingdom and the University of Eastern Finland in Kuopio. The study, which is published in the European Journal of Epidemiology, is based on 2,245 middle-aged men, who were followed for 20 years. During this period, the scientists found that the men who had the highest magnesium levels had the healthiest bone tissue, compared with those who had the lowest levels. Magnesium is involved in over 300 different enzymatic processes in the human body. One of magnesium’s functions is to channel calcium into bone cells and make sure it stays inside the cells in order to ensure strong

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bone tissue. In the cells of soft tissue such as muscles, however, magnesium has the opposite effect by preventing calcium from entering the cells. If too much calcium gets inside muscle cells, it may result in muscle cramps. When purchasing magnesium supplements, it is very important to choose a product like BioActive Magnesium that dissolves fast. A 30-second test will determine this. Simply drop a tablet of BioActive

Magnesium into a glass of cold tap water. Wait for exactly 30 seconds – and stir with a spoon. By then, the tablet has dissolved completely. In your stomach, the process is even faster. You can try with other magnesium brands and compare. You will be surprised – some tablets can sit in the water for hours without dissolving. BioActive Magnesium contains three different magnesium sources – magnesium carbonate,

magnesium acetate, and magnesium hydroxide – to provide the maximum effect of this vital nutrient. BioActive Magnesium from Pharma Nord will be in high demand due to a current Print Media campaign educating the people nationwide about the benefits of BioActive Magnesium. For more information or to place an order please call Pharma Nord on 01 899 1650 or email ireland@ pharmanord.com


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Who we are

Hugh’s House is a non-profit organisation providing free accommodation for parents of long-term ill children attending Temple Street Children’s Hospital, The Rotunda Hospital and The National Maternity Hospital Holles Street.

To sponsor us today visit the our go fund me link at : https://www.gofundme.com/mizen-to-malin-for-hugh-s-house www.hughshouse.ie/


Feature Management and Treatment of Osteoporosis Osteoporosis is a disease which causes the insides of a person’s bones which become fragile and break very easily. A person can look perfectly healthy on the outside but have severe undiagnosed Osteoporosis. Osteoporosis is known as the “Silent disease” However the effects of fractures are not Silent.

300,000 people affected but only 15% (20,000) are diagnosed, leaving 280,000 undiagnosed. We have an aging population, therefore these numbers are going to significantly increase. There are people in their 90’s who have improved their bone health, examples are on the Irish Osteoporosis website under patient stories. The reason it is so important that people check to see if they are at risk is because ¤500+ million was spent in 2013, just on treating fractures and this is estimated to go to one billion by 2025. Every day people are losing their independence from a disease that is preventable and treatable in the majority of people. What is Osteopenia? Osteopenia is the early stages of Osteoporosis, however research shows that more people break bones in the moderate to marked Osteopenia range than the Osteoporosis range. What are the Signs and Symptoms of possible undiagnosed Osteoporosis? • A broken bone caused by a trip and fall from a standing position or less: It is not normal to break a bone at any age from a trip

and fall. If a person’s bones are healthy they should not break so easily. With severe undiagnosed Osteoporosis, a person can cough, sneeze or turn over in bed and break a bone. • Loss of height: Many people believe that it is normal to lose height as you get older. However, if a person loses height, It is a red flag that they should get a DXA scan to rule out Osteoporosis. • A hump developing on the upper back or a person’s head protruding forward from their body: If it is from osteoporosis, the vertebrae in the spine are collapsing and will continue to collapse unless prevention/ treatment is put in place. • Upper, middle or low back pain: This could be a sign that a fracture has occurred, especially if the person has any of the signs or symptoms mentioned above. 50% of women with vertebral fractures are undiagnosed. Who does it effect? There are nearly 200 causes of bone loss, this is why it affects so many people. 50% of women and

25% of men over 50 will break a bone due to Osteoporosis and it effects all age groups, including children and a small amount of pregnant women. This is why it is essential that everyone check to see if they have risk factors for bone loss and ensure that they (and their children) have a diet rich in calcium and vitamin D, along with doing appropriate physically active. Those contemplating pregnancy need to ensure they do not have undiagnosed Osteoporosis and that they are taking the daily amounts of calcium and vitamin D. What supplements can you take/ would you recommend if you are suffering from Osteoporosis? There is a major problem worldwide of low levels of Vitamin D, particularly in postmenopausal women. In Ireland 74% of adults and 88% of primary school children, take less than half of the recommended daily amounts of vitamin D. Vitamin D is not only essential for bone health, but is also important for muscle function and balance. A deficiency of Vitamin D can cause rickets in children and osteomalacia in adults.

Unfortunately, Ireland does not have the weather for people to get their vitamin D from the sun throughout the year. Vitamin D is essential for the absorption of calcium. Milks supplemented by Vitamin D, fortified yogurts and oily fish are very easy ways for people to get their daily amounts. Pharmacists can offer supplements like Ideos Chewable Tablets, which provide patients with both calcium and vitamin D. A growing number of human metabolic, epidemiologic, and animal studies are indicating that low levels of Vitamin D, appear to be linked to the following conditions: Immune function diseases such as: Breast, colon and prostate cancer) Type 1 Diabetes and Multiple Sclerosis. Further research is required to prove/understand these links. Low Vitamin D levels have also been associated with TB and Fibromyalgia. Low levels of Vitamin D in a person can mimic the aches and pains of fibromyalgia. Lack of absorption of vitamin D may occur in gastrointestinal disorders such as Coeliac Disease (gluten sensitivity), Crohn’s disease or Ulcerative Colitis.

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Feature Note: Many people who get the blood test for Coeliac disease are negative. A person can be gluten sensitive, but not a true Coeliac. Therefore if a Coeliac test is negative but symptoms persist, a gluten and wheat free diet may reduce or eliminate symptoms. Altavita D 3 Calcichew D 3 Forte Osteofos D 3 What treatment suits which patients? The treatment a person goes on should be based on their age, medical history, the results from a DXA scan of their spine and hips, if they have broken a bone/s and the causes of their bone loss. All treatments should be combined with Calcium and vitamin D, unless the treatment (a few) have them in them already. What are the pharmaceutical treatments that are available to patients? HRT - Oestrogen/Hormone Therapy There are multiple brands available. They are oestrogen replacement for women going through the menopause and help to maintain bone density and reduce fracture rates for the duration they are on the treatment. Oestrogen therapy and oestrogen with progesterone hormone therapy are approved for the prevention of Osteoporosis in postmenopausal women provided there are no contraindications. They are usually recommended for post-menopausal symptoms to help improve the person’s quality of life. They may also be prescribed for premenopausal women who have amenorrhea and low levels of oestrogen.

Strontium Ranelate It has a dual action, it prevents bone loss and increases bone mineral density through the formation of new normal strong bone. The brand name is Protelos; one sachet with water daily Bisphosphonates which are also known as Antiresorptive medications These are non-hormonal drugs which help maintain bone density and prevent further bone loss. The following are a list of the brands of bisphosphonates: • Boniva® Can be given in tablet monthly • Boniva® Can be given by IV four times a year • Fosamax® - Can be given in tablet which is taken once weekly • Fosamax® plus D - Fosamax is a tablet which is taken weekly • Fosavance 5600 tablet which is taken once weekly • Actonel® - This is a tablet which can be taken daily /weekly • Actonel® with Calcium. Actonel Combi- Actonel is a tablet is taken weekly and Ca is taken the other 6 days • Actonel plus Ca & D , Actonel tablet is taken once weekly and a sachet the other 6 days • Aclasta® is a once-a-year IV Osteoporosis treatment. Parathyroid Hormone -(PTH) Bone forming agents that stimulates the formation of new bone which is for severe Osteoporosis and can only be prescribed by a Consultant.

Selective Oestrogen Receptor Modulators (SERMs) Bazedoxifine Acetate

• Forsteo = (1-34) It is given as a daily injection for 24 months

1) The brand name is Evista®. SERMs work in a similar way to oestrogen on bone by preventing bone loss in postmenopausal women who do not have hot flushes and also provided there are no other contraindications.

This is a surgical treatment which involves a balloon being placed within the fractured vertebrae, followed by a “bone cement” being injected into the balloon.

2) The brand name is Conbriza. SERMs work in a similar way to oestrogen on bone by preventing bone loss in postmenopausal women who do not have hot flushes and also provided there are no other contraindications. Monoclonal Antibody Denosumab, the brand name is Prolia. It is a Monoclonal antibody which binds to RANK Ligand, inhibiting the maturation of osteoclasts, thus protecting the bone from degradation.

Kyphoplasty

Vertebroplasty This is a non-surgical treatment which involves a needle with “bone cement” in it, inserted through the skin into the fractured body of the vertebrae. What advice should you give? 1) You need to find out if all the causes of their bone loss have been found and addressed. 99% of people who contact the Irish Osteoporosis Society, their causes of bone loss have been assumed not investigated. 2) The causes are found by extensive blood tests and an extensive questionnaire

3) You need to ask them if they are actually taking their medication, as well as the daily amounts of calcium and vitamin D. 70% of Osteoporotic patients stop taking their treatment within one year. 4) Are they getting enough calcium and vitamin D through food, therefore do they need a supplement 5) If they are not getting enough calcium and vitamin D through food, the importance of taking a supplement should be explained 6) You need to check if they have symptoms of gluten and wheat sensitivity as they may not be absorbing their treatments. 7) The Irish Osteoporosis Society recommend that people get DXA scans every two years maximum. This is to ensure they are improving and if they are declining it is caught quickly. If a person declines, it usually means that the causes of bone loss were not found and addressed OR they have been put on another treatment that causes bone loss OR developed a condition which causes bone loss OR their cortisol levels may be high due to stress from a divorce, spouse ill etc. Or they have been tested for Coeliac disease, told they are negative, they continue to eat them, yet they are sensitive to them. The Irish Osteoporosis society does not recommend a patient’s treatment just be switched onto another treatment if they decline, the cause of the decline must be found. Risk Factors The menopause is not the only cause for bone loss. There are nearly 200 causes of bone loss and it is essential that all causes of bone loss are found and improved in order for a person to improve their bone health.

Some of the most common causes are: Low levels of Vitamin D, Family history Osteoporosis, especially of a broken hip, the Menopause, Steroids, Gluten and wheat sensitivity, Chemotherapy, Radiation, Arimidex, Eating disorders, Stress, Depo-Provera, Steroid asthmatic inhalers, Many medications such as Warfarin and Heparin, water pills and excess alcohol and smoking to name a few. Below is an extensive list. Who is at risk of developing Osteoporosis? There are over 200 causes why a person can develop osteoporosis. Below is a list of some of the risk factors. You will notice that some of these are other diseases, some are treatments used to treat other diseases and some are secondary effects of a disease or lifestyle choices. • Family History: 80% of your bone is due to genetics therefore genetics is a strong risk factor especially, if there is a history of a hip fracture. • Eating disorders: Past or present history of anorexia and/or bulimia • Gastrointestinal Disorders: such as Coeliac, Crohn’s, Ulcerative Colitis or Primary Biliary Cirrhosis. • Rheumatoid Arthritis: the disease itself and steroid treatments. • Endocrine Disorders: such as High levels of Prolactin, cortisol or Thyroid hormone problems. • Asthma • Diabetes • Turner’s Syndrome • Klinefelter’s Syndrome • Haemochromatosis • Bone Marrow Disorders • Connective Tissue Disease • Multiple Sclerosis • Parkinson’s disease

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Feature Treating pets in Pharmacy

By Tomas Conefrey

A great opportunity is available to Pharmacists today in the form of over-the-counter medicines for dogs and cats. This is an area I became interested in two years ago after I noticed a lot of our customers have pets. Sometimes the pet was better looked-after in terms of medicines than the owner! Because we are limited in what we can sell this provides an advantage to us to specialise in these products. Fleas and Ticks Fleas and ticks are a curse for the animal kingdom, they can make the animals sick, and they can affect humans. One of the products we stock is called Parex. This contains an insecticide called Fipronil which can prevent both. There are two different types, feline and canine. It’s simple to use, application is via a pipette at the back of the neck- the animal can’t reach that spot, and their body does the rest. For dogs, there are four different types, depending on the size of the animal. Treatment lasts six weeks and covers fleas and ticks. Worming of Cats & Dogs The indicators for worms in dogs are relatively easy to spot- the bloated stomach and belly area is the one we all seem to be aware of. Other signs include worms or eggs in the faecal matter, around the dog’s rear, or in the fur around the anus. Another tell tale sign is when the dog is scratching or rubbing his bum across the ground or on furniture. Symptoms in cats are similar but can include lethargy in the animal and a dull coat. Bayer Animal Health has a range called Drontal, and they have several products within the range for worming your pet. The first product is called Drontal Puppy Suspension. This is used to treat roundworm infections in little puppies and young dogs up to twelve months old. The course is started when the pup is two weeks

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old, and is repeated every two weeks until the pup has been weaned. Not forgetting our feline friends, the next product is in tablet form, designed for Cats and Dogs. The Drontal Cat Tablets are recommended for cats with a body weight of 4kg (dosing guidelines come with the tablets for cats above or below this weight). One tablet is administered with or without food and is an effective combined treatment for roundworms and tapeworms. You can try and give your cat the tablet directly, but it is easier to hide it in their food. The Drontal Dog Tablets work in the very same way. When selling the tablets to my customers, I put the tablet in a little walletwhat I love about the wallet is it comes with four stickers. The idea is to stick them on the calendar at home, reminding you when the next dose is due. Shampoos/Products for skin treatment Animals can also suffer from skin conditions. Dermatitis and fungal infections like ringworm are a common enough occurrence in animals and it really needs to be treated properly.

Cattle, horses and dogs can be treated with a solution called Imaverol, a gentle emulsion designed to kill the infection while being gentle on the skin. If your dog has a fungal infection, he should be washed with the solution four times at three day intervals. While being washed with the diluted emulsion, the animal’s coat should be rubbed thoroughly in the opposite direction to the hair growth. This ensures the emulsion will get onto the skin, where the infection is. It is important to make sure all the skin is wet, and if the dog is long haired, the recommendation is to clip them before treatment. Treatment for cats with ringworm is usually a combination of tablets and a topical solution. Just like us, animals suffer the same fate when it comes to getting bitten by flies and other nasty creatures. Bites can cause skin irritation, and is as unpleasant for them as it is for us. Foran Skincare Powder helps to maintain healthy skin. It also contains Citronella, a fly repellent which keeps the insects away. A thick covering of powder is put onto the area where care is needed. The powder is gentle enough to be used daily.

Fleas are a nightmare for cats and dogs. If your animal gets infested with the hoppers, it can also become a real nightmare at home. The best cure for fleas is prevention. Bob Martin All-in-one Flea Spray is the answer. It is insecticide free, which means it is gentle to use. The spray can be put onto the animals, both dogs and cats, and can be used at home on bedding and furniture. The fleas won’t bite the pet in the first place when this spray is used, and it works on fleas at all stages of their life cycle. The spray can be used once a month. For dogs, Bob Martin Insecticidal Shampoo can be used to treat fleas on dogs and puppies over 12 weeks of age. Depending on the size of the dog, the number of doses in the bottle variesfrom 8 applications on a small dog, to 3 on a large dog like an Alsatian. Products for ear treatment We all have had ear aches at some point in our lives. It is a horrible pain, and can be caused for a number of reasons. Dogs too, can suffer from painful ear problems, specifically a condition called Canker. This condition is a build-up of wax


Feature in the dog’s ear, and our furry friends with droopy ears can be more prone to it that a dog with stand up ears. Clean Aural Spray is a routine ear cleaner for a dog which stops the wax building up and causing the condition. My advice is to use this spray regularly as a preventative measure, rather than trying to treat the condition itself. It is an organic solution designed to clean and moisturise the ears, and will soften and dissolve any wax build up. Other products/opportunities I have also found it possible to cross-promote with other businesses who met other needs of pets. Some local examples for me are a dog-groomer and a local Vet. I was surprised that the vet was receptive to my approach. I offered to take some

of his cards and tell customers about his practice which is relatively near to me it gave us a good base to start with. The dog-groomer has turned into a double-win as she buys some products from us also and we are very proactive in promoting her to customers. When they buy a product we have some cards of other businesses which pet-owners which may be interested in. We all love our animals, and we want to keep them safe and happy. They are prone to infections and ailments just like us, and like our children- we generally know when our pets are just not in the right form. If you feel that your pet is off colour in some way, be sure to take them to see a vet.

News NNIT signs deal with Novo Nordisk NNIT, a leading provider of IT services and consultancy, has announced that it has signed an extension of its infrastructure outsourcing agreement with Novo Nordisk. The estimated total value of the agreement amounts to approximately DKK 1bn and covers global services, including support and maintenance of Novo Nordisk's corporate IT infrastructure. The agreement covers Novo Nordisk's global IT infrastructure and further supports the pharmaceutical company's cloud strategy.

"The agreement marks the continuation of a long and successful collaboration between Novo Nordisk and NNIT," said, Jacob Hahn Michelsen, Senior Vice President, NNIT. "Novo Nordisk calls for very competitive solutions that have been tailored to the life science industry so we are proud to be able to match their high expectations." By 2020, approximately 34 million

diabetes patients worldwide will depend on Novo Nordisk medicine, and the global IT organization plays a key role in providing the IT infrastructure, systems and services needed to cater for this in an efficient, compliant and secure manner. "By choosing NNIT as a partner we have secured effective and efficient IT for an organization, which is growing globally, while

keeping ourselves ready to adopt the emerging technologies and build them into our solutions for tomorrow's business," explains Vincent Turgis, Chief Information Officer, at Novo Nordisk. The agreement is effective as of January 1, 2017 and runs until end 2022, replacing the existing agreement, which was set to expire by the end 2017.

New ‘multiple platform’ service Beautifuljobs have introduced a ‘multiple platform’ service for €190 where employers can advertise their jobs on the website and it is promoted on various platforms. The company now has over 6000 members and posts for companies such as The Body Shop, Waxperts, Image skincare, Human and Kind and The Skin Nerd. It includes social media marketing and a featured job listing to their members. They also offer a one to one recruitment service to clients

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who don’t have the time to do it themselves. The industry is growing and the jobs now aren’t just in Salons and Spa’s. With the current trend of people buying their beauty products and cosmetics more and more in the

Pharmacy, is broadening the scope of the beauty industry even further. Maria Morgan of Beautifuljobs says she understands how important it is to employ staff who not only provide five-star customer service but those who understand sales, psychology of selling and

the importance of having that customer return. She said ‘Introducing our services to the pharmacy sector is a natural progression’. With previous experience of directly providing temporary and permanent staff to the pharmacies and department stores in Dublin, Belfast and Cork.


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Awards The Irish Pharmacy

Red Carpet

2017

Over 650 professionals from Community Pharmacy across Ireland attended the Clayton Hotel, Burlington Road Dublin for the sixth annual Irish Pharmacy Awards. Hosted by Irish actress and comedienne Deirdre O’Kane, guests witnessed seventeen awards presented on the night as they helped celebrate innovation and excellence within their sector. Pictured are some of those who attended.

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7 1) Lisa Byrne, Jane Glennon, Pharmacist Rebecca O’Toole and Ciara Toolin, Adrian Dunne Pharmacy Group 2) Hayley Dempsey and Pharmacist Sarah Malone, Mangan’s Pharmacy, Newbridge 3) Professor Fabio and Ken Boylan, School of Pharmacy, TCD 4) Kristine and Kevin McCabe, Bradley’s Pharmacy 5) Marguerite O’Sullivan, Pharmacist Garvan Lynch and Emer O’Halloran, Lynch’s Pharmacy, Douglas 6) John Kelleher, Paula Cuddy, Louise Kelleher, Lorna Howard, Nicola Abbott, Leanne Hadley, Rachel Cornforth, Marie Farag, Josephine Joyce and Kieran Joyce, Cell Nutrition 7) Gabar Carslake, Aisling Cahill and Aga Mazur, Allcare Pharmacy Clearwater

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8) Michelle Hourigan, Sharon Madden, Superintendent Pharmacist Mark Sajda and Gillian O’Connor, Sam McCauley Chemist Group


Nicole Scherzinger announced asNicole Perfectil Brand Ambassador Scherzinger announced

Perfectil is excited toBrand announce singer-songwriter, as Perfectil Ambassador actress and television personality Nicole Scherzinger excited to announce singer-songwriter, as Perfectil the newisface of one of Ireland’s leading beauty actress and television personality Nicole Scherzinger vitamin brands. as the new face of one of Ireland’s leading beauty vitamin brands. Nicole, who has been a fan of Perfectil vitamins for

years, says, “My supplement is Perfectil. Nicole, who hasgo-to been abeauty fan of Perfectil vitamins for I added it to my daily regime and within weeks my years, says, “My go-to beauty supplement is Perfectil. nails wereitstronger, likeand mywithin skin and hairmywere I added to my dailyI felt regime weeks nails were I felt like myever skin and hair were glowing andstronger, more radiant than before; I can’t glowing andPerfectil more radiant than ever before; I can’t recommend enough.” recommend Perfectil enough.”

This summer, the Perfectil range can be seen on TVs This summer, the Perfectil range can be seen on TVs across Ireland when it begins its heavy national TV across Ireland when it begins its heavy national TV campaign on the 1st of July 2017. campaign on the 1st of July 2017. Contact your SalesRepresentative Representative today or Offices our Offices on 01-404 7300 Contact yourValeo Valeo Healthcare Healthcare Sales today or our on 01-404 7300 for morefor more information products,asaswell well exclusive point of for salethe forTVthe TV campaign. informationon onPerfectil Perfectil products, asas exclusive point of sale campaign.


Pharmaher Healthcare Launches Contact Lens Friendly Eye Care Range Pharmaher Healthcare have just launched Vizulize, the ultimate contact lens friendly eye care range into Irish pharmacy. Vizulize offers a comprehensive range of safe, effective and value for money contact lens friendly products. The range uses a contact friendly preservative, unlike most licensed eye drops. The range is isotonic, which means it won’t dry out the eyes and has a natural PH balance of 7.2 which is the same as tear fluid so it doesn’t sting. Vizulize products irrigate and lubricate dry, tired and sensitive eyes. They provide long-lasting relief to red and uncomfortable eyes resulting from daily eye problems such as dry environments, computer work and contact lens wear. As well as affordable and high quality contact lens solutions, the Vizulize range includes eye drops, sprays and washes. For further information on the Vizulize range please talk to your Pharmaher Healthcare sales representative or contact us directly on 041 9882255, email info@pharmaher.ie or check out www.pharmaher.ie.

FLIP-FLOPS, THE FOOTWEAR OF CHOICE, DREADED BY MANY THIS SUMMER Despite longing for warmer weather all winter long, and investing in new shades of polish, when summer finally does appear, the woeful state of our feet often suggests its arrival is somewhat unexpected, according to healthcare brand Clonmel Healthcare.

Despite misconceptions, cracked feet, when untreated, can cause pain to walk, and may lead to infection and other more developed conditions. The Flexitol range is effective, affordable and readily available to ensure smoother, softer feet this summer. The Flexitol family of products includes Flexitol Heel Balm, a clinically proven, 25% Urea based formulation, which gets to work moisturising cracked heels immediately, Flexitol Platinum (with 30% Urea) and Flexitol Moisturising Foot Cream (with 10% Urea), which is suitable for everyday use, to help maintain healthy skin on the feet and legs.

MyPro is a brand new range of 2nd generation probiotics designed for specific concerns. The first in the MyPro range to be launched is Iro-Sorb, a clinically proven formulation that helps solve iron deficiency in a completely new way.........by increasing the uptake, not only the intake! Containing the hero strain of LP299V, MyPro Iro-Sorb also contains a folic acid booster and added Vitamin C to help increase the iron absorption. Gentle to the gastrointestinal system. Patent protected. Suitable for women of child bearing age and also people with active lifestyles. RRP €19.95

Ocean Healthcare launches - PROCEIVE, the Advanced Fertility Supplement Ocean Healthcare is delighted to announce the launch of PROCEIVE, the Advanced Fertility Supplement for men and women. PROCEIVE’s comprehensive formulations including folic acid, amino acids, vitamins and minerals to support fertility and nutritional deficiencies associated with reproduction. The range is suitable for all couples with the MAX formula specially formulated for women over 35/men over 40 or those who have been trying for a baby for one year or more. The launch is backed by an intensive digital campaign including google AdWords, Facebook advertising, Banner advertising and Blogger activity. TV activity will commence in June. A range of impactful shelf highlighters are available from our sales team or from Ocean Healthcare 01 2968080

www.proceive.ie 96


Clinical Profiles BIONTECH ANNOUNCES POSITIVE RESULTS OF AN INTERNATIONAL REPRODUCIBILITY STUDY WITH MAMMATYPER® BioNTech Diagnostics GmbH announced the publication of an international prospective multicenter study that demonstrates the high reproducibility of the MammaTyper® in vitro diagnostic test. MammaTyper® determines the mRNA expression of the St. Gallen Guideline-recommended biomarkers HER2 (ERBB2), ER (ESR1), PR (PGR) and the proliferation marker Ki-67 (MKI67) by reverse transcription quantitative real-time PCR (RTqPCR). In this study, ten renowned pathology laboratories – Prof. Varga (Zurich), Prof. Lebeau (Lübeck), Prof. Bu (Chengdu, China), Prof. Hartmann (Erlangen), Prof. Penault-Llorca (ClermontFerrand), Prof. Symmans (Houston, Texas), Prof. Teng (Hangzhou, China), Prof. von Wasielewski (Hannover), Prof. Bartlett (Ontario, Canada) and Prof. Viale (Milano) – analyzed the same clinical breast cancer tissue samples using the MammaTyper® test. The results were subsequently analyzed for their reproducibility both between the institutes (intersite) and within each institute (intra-site). The data shows that MammaTyper® provides virtually identical results – independent of the location, the time of day, the instruments used and the operator performing the test (1). “The very precise reproducibility of MammaTyper® compared to immunohistochemistry was shown, especially for the determination of the proliferation marker Ki-67, which is vitally important for the differentiation of luminal breast cancer types and for the prognosis“, explained the head of the study, Prof. Dr. med. Zsuzsanna Varga, University Hospital of Zurich. “The study shows impressively that MammaTyper® has the potential to significantly increase not only the current standards but also the quality of breast cancer diagnostics“, affirms Dr. Sierk Pötting, CEO BioNTech Diagnostics GmbH. The precise and reliable determination of the four biomarkers HER2 (ERBB2), ER (ESR1), PR (PGR) and Ki-67 (MKI67) is a key parameter that supports breast cancer therapy decisions. Ki-67 is of special interest in this respect, since in patients with luminal tumors, which are ER- and/or PR-positive and HER2-negative, the decision

for or against chemotherapy is increasingly made on the basis of the Ki-67 value. The established immunohistochemistry (IHC) method has, however, been subject to review for some time – especially in terms of the reproducibility and comparability of Ki-67 results (2,3). The recently published study examines whether the MammaTyper® in vitro diagnostic test is able to supply reliable and reproducible results for the mRNA expression of the genes ERBB2, ESR1, PGR and MKI67. Ten internationally recognized pathology laboratories participated in the study, which was subdivided into two arms. In the first study arm, each institute analyzed RNA samples that had been centrally extracted from formalinfixed paraffin-embedded (FFPE) breast cancer tissue samples. In the second arm, each institute was provided with FFPE tissue sections, from which RNA was locally extracted using the RNXtract® kit, to also take into account a possible variance through the preparation of the samples. On several days, each institute repeatedly examined each of these samples with the MammaTyper®. The reproducibility of the quantitative results for the individual markers both between and within the institutes was calculated by means of variance component analysis and the intra- and inter-class correlation coefficient (ICC). In the process, the ICC reflects the reproducibility of quantitative results over the entire measuring range (4). Furthermore, the agreement of positive/negative marker results and the subtype classification were interpreted on the basis of Fleiss‘Kappa values. The first study arm examined the comparability of quantitative marker results (40-ΔΔ Cq values) between the ten sites. The total standard deviation of measurements of centrally extracted samples was merely 0.29 Cq for ERBB2, 0.44 Cq for ESR1, 0.18 Cq for PGR and 0.29 Cq for MKI67. Agreement of the four markers in locally extracted samples was similarly high. The mean deviations of individual markers over all samples at one site were close to zero, with values between -0.22 and 0.31 (1). Within the laboratories, ICC values of the quantitative determination of all markers ranged from 0.976 to 0.996, and across locations from 0.980 to 0.998, which demonstrates excellent precision of the quantitative determination. Inter-site reproducibility of the positive/negative marker results was also correspondingly high –

with Kappa values of 1.00, 0.91, 0.94 and 0.94 for ERBB2, ESR1, PGR and MKI67. The resulting subtype definition was virtually identical, with a Kappa value of 0.90 at the ten sites (1). In contrast, IHC in comparable studies for Ki-67 only reaches an ICC value of 0.71 across the sites with local staining (2). Even with centralized staining, the IHC inter-site ICC values were similar – between 0.40 and 0.74, with Kappa values from 0.29 to 0.58 (5). “The study proves the outstanding reproducibility of MammaTyper®. Thus, MammaTyper® has the potential to improve significantly the quality and reliability of breast cancer diagnostics“, Prof. Varga sums up. The newly published data support the already published studies, which had substantiated the analytical precision of MammaTyper® and its high reproducibility compared to the established IHC method (6,7).

EUROPEAN REGULATORS APPROVE FIRST IN MAN CLINICAL TRIAL OF NOVEL CELL THERAPY FOR DIABETIC KIDNEY DISEASE NUI Galway-coordinated NEPHSTROM project announces European clinical trial approval to treat diabetic kidney disease Tuesday, 9 May, 2017: NEPHSTROM, a large European Union Horizon 2020-funded research project coordinated by NUI Galway has successfully completed a major step in the European clinical trial approval process. NEPHSTROM, which includes 11 academic, clinical and commercial partners from Ireland, Germany, the Netherlands, Belgium, Italy and the UK, is carrying out a randomised, placebo controlled clinical trial of a novel allogeneic stromal cell therapy to treat diabetic kidney disease. Diabetic kidney disease (DKD) is the single leading cause of end stage renal disease in the industrialised world, accounting for 40% of new cases of end stage renal disease in the US and EU. The five-year mortality rate is 39% – a rate comparable to many cancers. To address the critical unmet need for a therapy for DKD, NEPHSTROM brings together key leaders in the clinical treatment of chronic kidney disease, leading researchers of the mechanisms of diabetic nephropathy, and experts

in stromal cell therapy development in a multi-disciplinary team. The NEPHSTROM team is carrying out a first in man Phase 2a clinical trial of a novel stromal cell therapy (ORBCEL-M) for diabetic kidney disease. ORBCEL-M was discovered by Dr Stephen Elliman, Chief Scientific Officer at Orbsen Therapeutics, an NUI Galway spinout cell therapy company. ORBCEL-M has demonstrated significant improvements in kidney function in pre-clinical models of DKD. The NEPHSTROM clinical trial represents a significant step towards preparing this therapy for clinical use. The pan-European NEPHSTROM clinical trial is being led by the renowned nephrologist, Professor Giuseppe Remuzzi at the Mario Negri Institute in Bergamo, Italy with clinical trial recruitment sites in Italy, Ireland (HRB Clinical Research Facility, Galway), and the UK (UHBFT, Birmingham and BHSCT, Belfast). The primary aim of the clinical trial is to establish the safety and efficacy of ORBCEL-M. The NEPHSTROM team of researchers also hope to show that important markers of DKD are improved, meaning that the therapy actually works, as well as being safe. An important milestone in this clinical trial is the successful completion of a voluntary harmonisation procedure (VHP). The VHP is designed to simplify clinical trials across multiple European member states by providing a centralised application procedure for clinical trial approval. Since the NEPHSTROM project commenced, the team have been compiling the data and preparing the documentation required for a voluntary harmonisation procedure submission. Following a submission to AIFA, the Italian Medicines Agency, the NEPHSTROM trial successfully secured VHP approval on 4 April 2017. Commenting on the approval, Professor Timothy O’Brien, Dean of the College of Medicine, Nursing and Health Sciences at NUI Galway, and the coordinator of NEPHSTROM, said: “This approval is a vital step towards the successful completion of the NEPHSTROM trial. Achieving this has involved a tremendous amount of work on the part of the whole NEPHSTROM team.” Patient enrolment for the NEPHSTROM trial is expected to commence in the summer of 2017.

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Clinical Profiles CROWN BIOSCIENCE ANNOUNCES COLLABORATION TO DEVELOP CYTOTOXIC T-LYMPHOCYTEASSOCIATED PROTEIN 4 (CTLA-4) ANTIBODY SANTA CLARA, Calif., May 08, 2017 (GLOBE NEWSWIRE) -Crown Bioscience, a wholly-owned subsidiary of Crown Bioscience International (TWSE: ticker 6554) and a global drug discovery and development services company providing translational platforms to advance oncology and metabolic disease research, announces a collaboration to develop a CTLA-4 antibody with Jiangsu Qyun BioPharmaceutical Co. Ltd. As part of the collaboration agreement CrownBio will leverage Jiangsu Qyun BioPharmaceuticals expertise to support the Investigational New Drug Application (IND) and further clinical development of CrownBio’s proprietary 10B10 antibody. “The collaboration agreement between CrownBio and Jiangsu Qyun Bio-Pharmaceutical Co. Ltd is indicative of our focus on innovation, and enhances our portfolio in immuno-oncology,” said Jean-Pierre Wery, CEO of CrownBio. “Moreover, this partnership highlights CrownBio’s commitment to develop therapies that could significantly impact the way cancer is treated.” 10B10 is a humanized antiCTLA-4 antibody with higher binding affinity and in vitro T cell stimulation than ipilimumab, the first immune checkpoint blockade antibody targeting CTLA-4 to receive FDA approval for the treatment of melanoma. The two antibodies have equivalent activity in T cell activation and tumor growth suppression but a different binding epitope and pharmacokinetic profile. The goal of the collaboration between CrownBio and Jiangsu Qyun Bio-Pharmaceutical is to develop a less toxic CTLA-4 antibody and better combination strategies to overcome the immunological adverse effects due to T cell activation and proliferation observed in a minority of patients treated with anti-CTLA-4 immunotherapies. “CrownBio is the ideal partner to progress candidate compounds to IND and clinical development thanks to their recognized in vivo pharmacology expertise and the high quality and standards of their operations, representing the perfect match to our knowhow in antibody engineering, cell line construction, and experience in

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GMP production management, quality control, clinical research, and regulatory affairs,” said Qiu Jiwan CEO of Jiangsu Qyun BioPharmaceuticals. For more information on CrownBio’s commitment to furthering the field of oncology and metabolic disease drug discovery, visit https://www.crownbio.com. About Crown Bioscience Inc. Crown Bioscience is a global drug discovery and development solutions company providing translational platforms to advance oncology and metabolic disease research. With an extensive portfolio of relevant models and predictive tools, Crown Bioscience enables clients to deliver superior clinical candidates. About Jiangsu Qyun Bio-Pharmaceutical Co. Ltd Jiangsu Qyun Bio-Pharmaceutical Co. Ltd was founded in June 2015 with registered capital of 90 million yuan. The company is focused in the development and production of antibody drugs. The company’s founding team is composed of both expat and domestic bio-pharmaceutical industry experts who have engaged in multiple successful monoclonal antibody drug development projects. Their expertise covers antibody engineering, cell line construction, process development, quality analysis and development, with extensive and rich experience in GMP production management, quality control, clinical research and regulatory affairs. Qyun adheres to the corporate philosophy of “science, conscience and dignity”. Through the discovery and development of innovative antibody products the company’s goal is to alleviate patient suffering while increasing patient dignity

90% OF IRISH PARENTS WORRY ABOUT THE PRODUCTS THEY USE ON THEIR CHILD’S SKIN – ACCORDING TO A NEW OILATUM JUNIOR SURVEY 90% of Irish parents worry about the products they use on their child’s skin according to a new survey on children’s skincare conducted by Oilatum Junior, the Irish-made skincare range for dry skin. The survey was commissioned by GSK, the makers of Oilatum Junior as part of their ‘Take Comfort in Our Science’ campaign with over 1,100 parents taking part in the

online poll. The campaign is aimed at educating parents about their childrens’ dry skin conditions and the importance of science when it comes to creating the right dermatologically based product for these conditions. The findings show that 55% of children in this survey experienced dry skin while just over half of the children in this survey suffered from eczema. The impact of these conditions can be wide-ranging, with parents reporting symptoms such as physical discomfort, not being able to take part in physical activity and interrupted sleep. Emollient creams are the most popular product for treating these conditions, with over half of those questioned saying they find emollients most effective. The survey shows that 80% of parents read the ingredients list when selecting skincare products for their children. Worryingly, almost a quarter of parents (23%) feel they have little understanding of the science behind treating skin conditions such as eczema and almost two thirds of parents admitted they have limited or no understanding of the function of the ingredients listed on a product. 76% of parents rely on their GP for advice about their child’s skincare condition and 60% have asked their pharmacist while 25% of parents admit to turning to online sources for advice and support. Over 30% of parents have to distract their child while applying cream and some of the tactics used include cuddles, electronics, books, food and games. After bath time is the most popular time for moisturizing (56%) whereas 12% of parents choose to moisturize their child’s skin a number of times a day. Almost 90% of parents purchase skincare products in a pharmacy, with two thirds saying knowing their child skincare product was made in Ireland would affect their decision to buy. Key themes also affecting parents decision to buy are, in order of importance, the products ingredients, an endorsement from a GP or pharmacist, credibility of the producer, research led science and endorsement from a celebrity.

RELVAR ELLIPTA SIGNIFICANTLY IMPROVED ASTHMA CONTROL IN SALFORD LUNG STUDY PATIENTS COMPARED WITH THEIR USUAL CARE GlaxoSmithKline plc (LSE/NYSE: GSK) and Innoviva Inc (NASDAQ:

INVA) have announced positive results from the innovative Salford Lung Study (SLS) in asthma, carried out amongst 4,233 patients treated by their own General Practitioner in everyday clinical practice. This open-label, randomised study showed that significantly more asthma patients initiated on treatment with Relvar Ellipta 100/25mcg or 200/25mcg (fluticasone furoate ‘FF’/vilanterol ‘VI’ or ‘FF/VI’) achieved an improvement in their asthma control compared with patients who continued to take their usual care medicines. Usual care treatment included inhaled corticosteroids (ICS) administered as monotherapy or as ICS/LABA (Long Acting Beta Agonist) combinations. For the primary effectiveness analysis, at 24 weeks a significantly higher percentage of patients with uncontrolled asthma and initiated on treatment with FF/VI achieved better control of their asthma (71%) measured by the Asthma Control Test (ACT), compared with patients continuing usual care treatment (56%), (Odds ratio 2.00, 95% CI 1.70, 2.34; p<0.001). Improvement was defined as an ACT total score ≥20 or an increase from baseline of ≥3. Statistically significant findings were also seen at 12, 40 and 52 weeks. In the study for the intent-to-treat (ITT) population, the incidence of serious adverse events (SAE) was the same in both arms (FF/ VI 13% and usual care 13%). Pneumonia was a safety endpoint of special interest and a regulatory post-authorisation requirement of the European Medicines Agency (EMA). A novel aspect of the study design was that it allowed patient’s treatment to be modified throughout the study. Therefore two assessments relating to pneumonia have been performed, one based on the arm to which patients were randomised, the second based upon the treatment to which patients were exposed at the time of the event. Serious adverse events of pneumonia by randomised group were reported by 39 patients (FF/VI arm 23, 1%; usual care arm 16, <1%). These patients had 42 events and based on a pre-planned analysis non-inferiority of FF/VI to usual care was not confirmed. When these events were summarised according to the actual treatment patients were taking at the time of the event, 21 events were recorded for FF/VI and 21 events for usual care.


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starts relieving hayfever eye symptoms in just 2 minutes Opticrom Allergy Single Dose Eye Drops Preservative free Suitable for use with contact lenses* Handy for on-the-go use Suitable for adults and children * Refer to instructions for use with contact lenses. Contact lenses should be removed before each application and inserted after 15 minutes.

FOR MORE INFORMATION CONTACT YOUR SANOFI REPRESENTATIVE Padhraic Speight Tel: 086 0456 817 Munster

Colm Moran Tel: 086 0470 989 Midlands, North West

OPTICROM ALLERGY SINGLE DOSE 2% W/V EYE DROPS, SOLUTION PRODUCT INFORMATION Presentation: Eye Drops containing Sodium Cromoglicate 2% w/v. Indications: For the relief and treatment of seasonal and perennial allergic conjunctivitis. Dosage & Administration: One or two drops in each eye up to four times a day. Treatment should be continued during the period of exposure to allergen. Contraindications: Hypersensitivity to ingredients. Precautions and Warnings: Should be used immediately after opening and any remaining contents discarded after use. Contact lenses should be removed before each application and may be inserted after 15 minutes. Pregnancy and Lactation: Caution should be advised especially during 1st trimester of pregnancy. Although experience with sodium cromoglicate suggests that it has no effect on foetal development, it should be used only when there is a clear need. It is not known whether sodium cromoglicate is excreted in human breast milk. There is no information to suggest that this has an undesirable effect on the breastfed baby. Effects on ability to drive and use machines. As with all eye drops, instillation of these eye drops may cause a transient blurring of vision or cause local irritation that could impact driving or operating machinery. Do not drive or operate machinery if affected. Adverse Effects: Transient stinging, burning and blurring of vision may occur after instillation. Other symptoms of local irritation have

Laurence Oâ&#x20AC;&#x2122;Carroll Tel: 086 0456 816 East Coast

been reported. Hypersensitivity reactions have been reported. Legal Category: P. Pharmaceutical Precautions: Store below 25°C. Keep the single dose containers in the aluminium sachet to protect from light. Discard any remaining contents after use. PL number: PA0540/116/003. For full information please refer to individual Summary of Product Characteristics. Date of preparation: February 2017. Further information is available from the Marketing Authorisation Holder: Sanofi Ireland Ltd. 18 Riverwalk, Citywest Business Campus, Dublin 24 or contact IEmedinfo@sanofi.com Tel: (01) 4035600. Reporting suspected adverse reactions after authorisation of the medicinal product is important. It allows continued monitoring of the benefit/risk balance of the medicinal product. Healthcare professionals are asked to report any suspected adverse reactions via HPRA Pharmacovigilance, Earlsfort Terrace, IRL - Dublin 2; Tel: +353 1 6764971; Fax: +353 1 6762517. Website: www.hpra.ie; E-mail: medsafety@hpra.ie. Suspected adverse events can also be reported to Sanofi Ireland Ltd. directly by emailing IEPharmacovigilance@Sanofi.com or calling 01403 5600. Date of preparation: April 2017 SAIE.CRO.17.04.0075

June 2017 - Irish Pharmacy News  
June 2017 - Irish Pharmacy News